Maurine Rofhiwa Musie

Background: Women in sub-Saharan Africa experience a disproportionate burden of HIV/AIDS. Self-management of HIV is influenced by sociocultural and economic factors that shape adherence and well-being. Aim: To explore and describe the perception of women regarding their needs, preferences and cultural practices influencing self-management of HIV/AIDS in Northern Ghana. Setting: Antiretroviral therapy (ART) clinics in three main hospitals in Northern Ghana: Tamale Teaching Hospital, Northern Regional Hospital and Tamale West Hospital. Methods: A qualitative, exploratory and descriptive design was utilised for this study. Twenty women were purposively recruited. Data were collected using semi-structured in-depth interviews. Thematic analysis, guided by Braun and Clarke’s six-step framework was conducted with NVivo 15.2 to organise codes and themes. Results: Analysis within the perception, enablers, and nurturers (PEN-3) model identified: (1) perceptions of needs for self-management: knowledge of HIV disease process, consistent access to ART, well-organised clinic services and preference for long-acting injectables to reduce pill fatigue; (2) enablers: credible communication channels (mosques, churches, community durbars, festivals, local language media) and moderated digital supports such as WhatsApp reminders and clinic micro-lessons; (3) nurturers: comprised partners, family members, trained peers and digital peer networks that provided reminders and encouragement. Conclusion: Self-management of HIV/AIDS among women in Northern Ghana extends beyond medication adherence to include psychosocial and cultural dimensions. Contribution: Identifying women’s needs and preferences for HIV/AIDS self-management, and how religion, sociocultural and contextual factors uniquely shape their ability to manage their condition, providing evidence for culturally relevant, women-centred education programmes.

Introduction: Partograph monitoring aims to assist midwives, obstetricians, and other healthcare professionals in a midwifery/obstetric unit to diagnose and manage labor to reduce the risk of prolonged labor, augmentation, cesarean sections, shoulder dystocia, and intrapartum stillbirths. The modified partograph is a new evidence‐based labor monitoring tool to assist with assessment and decision‐making during labor. Delayed implementation of the modified partograph was observed in the obstetric unit of the particular public hospital, while the previous partograph remained in use. It was not clear what barriers were related to the delayed implementation. Aim: The aim was to describe the perceived barriers by midwives to implementing the modified partograph in the obstetric unit of a public hospital in Gauteng province, South Africa. Methods: A qualitative descriptive contextual design was followed. The total population of all employed midwives at the hospital's obstetric unit was invited, focus groups were conducted until data saturation was reached, and data were analyzed using thematic analysis. All participants who met the inclusion criteria were invited. Results: Barriers identified included inadequate roll‐out of the modified partograph, insufficient understanding of the differences between the old and modified partographs, and material resource challenges. Conclusion: Recommendations were made to overcome the barriers. The study stressed the need to roll out the modified partograph across all levels of care and to all relevant stakeholders, including the importance of adequate training. Sustained training, mentorship, audit systems, and health‐system strengthening should be introduced to prevent confusion about the interpretation of the differences between the partographs and how to ensure complete record keeping.

Background: Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality globally. Effective management of PPH demands the implementation of E-MOTIVE bundle for early detection and management of PPH as recommended by the World Health Organization (WHO). Aim: The scoping review aimed to map evidence on the implementation of the E-MOTIVE bundle for early detection and management of PPH emergencies globally. Methods: The review adopted the Arksey and O’Malley methodological framework (2005). Six databases (CINAHL, MEDLINE, Scopus, PubMed, Web of Science and ProQuest) were searched for sources. The inclusion criteria consisted of full-text articles in English published between 2015 and 2025. Results: A total of 14 articles were selected. The review revealed: 1. Types of PPH bundles, 2. Implementation strategies of E-MOTIVE bundle. 3. Barriers to effective implementation of the E-MOTIVE bundle. Conclusion: A bundled care approach for the management of PPH following vaginal delivery has been shown to reduce adverse maternal outcomes because of PPH. Contribution: The review addresses a critical gap in the implementation and suggests implementation strategies of the E-MOTIVE bundle, including objective blood loss estimation, scalable training, adoption to national policies and teamwork among the obstetric team.

Introduction: Women of Reproductive Age (WRA) living with HIV/AIDS face challenges in managing their condition due to cultural, social, and structural barriers. Culturally appropriate Self-Management Education Programs (SMEPs) offer promising strategies to enhance engagement in HIV care and psychosocial well-being. However, limited evidence exists on how these programs integrate cultural dimensions into HIV care and management. This scoping review aimed to identify and synthesize evidence on culturally adapted SMEPs for Women of Reproductive Age (WRA) living with HIV/AIDS, with a focus on how cultural factors are incorporated into program design and delivery. Method: The review followed Arksey and O’Malley’s framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR) reporting guidelines. A comprehensive search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and grey literature sources (https://opengrey.eu/) from 2013 to 2024. Studies were included if they focused on culturally tailored SMEPs for WRA living with HIV/AIDS. Results: Fifteen studies were included and analysed thematically. Fifteen studies met the inclusion criteria. The majority of the studies were Thematic analysis revealed five core themes: (1) cultural competence in HIV care; (2) impact of cultural alignment on HIV self-management outcomes; (3) facilitators of SMEP implementation; (4) barriers to culturally appropriate care; and (5) implementation strategies for SMEPs. Studies reported improved Antiretroviral Therapy (ART) adherence, viral suppression, and psychosocial outcomes when SMEPs incorporated culturally congruent content, peer-led delivery, and community-based methods. Barriers included stigma, patriarchal norms, and limited healthcare access, while facilitators encompassed peer support, family involvement, and culturally sensitive curricula. Discussion: The findings of the study underscore that a culturally tailored self-management education program enhances psychological well-being, ART adherence, and engagement in HIV care among women of reproductive age. The results highlight the significance of integrating cultural competence into HIV programs to ensure equity, sustainability, and broader global applicability in diverse healthcare settings. Conclusion: The review underscores the potential of culturally tailored SMEPs to improve health and psychosocial outcomes among women living with HIV/AIDS. However, interventions remain unevenly distributed and often lack standardization in cultural adaptation. Future efforts should prioritize inclusive program design, implementation in underrepresented regions, and evaluation frameworks that account for diverse cultural contexts.

Background: South Africa has made considerable progress in HIV and AIDS management, particularly in vertical transmission prevention (VTP). The 2023 national HIV guidelines, which includes provision for pregnant and breastfeeding women, mark an important advancement. However, implementation in the private healthcare sector remains uncertain. The effective application of antiretroviral therapy (ART) guidelines in maternity wards within private hospitals is essential to prevent vertical transmission of HIV.Aim: This study explored midwives’ perspectives on the implementation of ART clinical guidelines for preventing vertical HIV transmission in maternity wards within a private hospital in Gauteng province.Setting: The study was conducted in a maternity ward of a private hospital in the Tshwane District, Gauteng, South Africa.Methods: A qualitative, exploratory, descriptive design was used. Thirteen purposively selected midwives participated in in-depth, semi-structured interviews, which were audio-recorded with consent, transcribed verbatim and thematically analysed to develop themes.Results: Four themes emerged: (1) Lack of standardised practice in implementing VTP guidelines; (2) Ethical and confidentiality challenges; (3) Limited role of midwives in VTP management; and (4) Strategies to enhance implementation and use of ART clinical guidelines in private hospitals.Conclusion: The findings highlight challenges in implementing ART guidelines in private maternity settings and emphasise the need for stronger integration of national HIV guidelines through training, policy alignment and institutional support to improve maternal and neonatal outcomes.Contribution: The study presents recommendations for strengthening the role of private hospitals in reducing vertical HIV transmission and supporting HIV and AIDS elimination goals.

The integration of digital learning in nursing and midwifery education is increasing worldwide. The COVID-19 pandemic accelerated the adoption of digital learning as a primary instructional medium in higher education, enabling the delivery of content to nursing and midwifery students with varied learning needs in both academic and clinical contexts. Digital technologies, including podcasts, high-fidelity virtual simulations, and ESMOE videos, have been incorporated not only for theoretical instruction but also for clinical teaching to enhance psychomotor learning. This study aimed to explore the perspectives of midwifery educators regarding the integration of digital learning in midwifery education at selected universities in Gauteng Province, South Africa. A descriptive and exploratory qualitative research design was employed. Data was collected via Microsoft Teams using a semi-structured interview guide at selected universities in Gauteng Province, South Africa, offering undergraduate nursing degrees. Thirteen midwifery educators participated. Open coding was utilised to compile and analyse the data. Two themes emanated from the findings of the study, indicating midwifery educators’ views regarding the integration of digital learning in midwifery education, namely: 1) enablers of integrating digital learning in midwifery education and 2) challenges of integrating digital learning in midwifery education. This article will discuss both themes. Key recommendations include enhancing institutional support, providing educators with sufficient training to develop their digital competencies, and ensuring that updated digital resources are accessible to both educators and students. These measures can maximise the benefits of digital learning, even beyond the immediate impacts of the COVID-19 pandemic. Digital learning plays a significant role in teaching and learning by enhancing student success and fostering creative and critical thinking skills for clinical management. It enabled educators and students to continue educational activities despite the disruptions caused by the COVID-19 pandemic.

Background: Birth companion support has been globally recognised as an essential component of childbirth care for decades. The benefits of birth companion support care include providing the pregnant woman with continuous emotional and physical support, thereby promoting positive childbirth experiences. Despite the numerous benefits of birth companion support care and the availability of policies to support this intervention, its implementation remains challenging. Objectives: This study aimed to “map the evidence” and “identify gaps” in implementation strategies to enhance birth companion support. Methods: This scoping review adhered to the framework developed by Arksey and O'Malley, which comprised (i) developing the research question, (ii) identifying applicable studies, (iii) choosing studies, (iv) charting data, and (v) compiling, summarizing, and reporting findings. The databases utilized were PubMed, ProQuest, Scopus, and Web of Science. The findings of the review were analysed using thematic analysis. Results: This scoping review encompassed 14 studies, and the results were divided into two main sections. Section A included identified implementation strategies covering the following themes: Models for implementing birth companion support, Development of programs for implementing birth companion support, and Task shifting. Section B entailed factors affecting the implementation of birth companion support, which are facilitators and barriers to the implementation of birth companion support. Discussion: Continuous in-service training and workshops given to the target groups of health care professionals on the benefits of birth companion care and the roles of the companions will raise awareness and guarantee the implementation of birth companion support care during labour and childbirth. The significance of this practice lies in its ability to enhance a positive childbirth experience, which is essential for high-quality care. Conclusion: The evaluated studies were conducted in nations with high, moderate, and low incomes. There was less evidence of a birth companion care implementation study conducted in South Africa. The findings of this study will assist in creating awareness and readiness for implementing birth companion support care in clinical practice.

Background: Nurses play a central role in upholding patients’ rights; yet in many health facilities, these rights are frequently compromised. Understanding these challenges is essential for developing effective improvement strategies and ensuring ethical, patients’ rights-centred care in health facilities. Aim: To explore and describe the challenges faced by nurses in upholding patients’ rights in selected health facilities within the Capricorn District, Limpopo province, South Africa. Setting: The study was conducted in four health facilities, including a tertiary hospital, district hospital, clinic, and healthcare centre. Methods: A qualitative, exploratory, descriptive, and contextual design was used. Data were collected through semi-structured interviews with 28 conveniently sampled nurses from different nursing categories. Data were analysed using Tesch’s open coding method. Results: Three themes with six subthemes were identified: (1) resource deficiencies as barriers hindering nurses’ ability to uphold patients’ rights; (2) nurses’ difficulties in upholding patients’ rights in health facilities; (3) infrastructure constraints affecting nurses’ ability to uphold patients’ rights in health facilities. Conclusion: The findings reveal that nurses’ ability to uphold patients’ rights is challenged by interrelated resources, patient-related, and infrastructure barriers. Addressing these challenges through adequate staffing, supply provision, infrastructure improvements, and supportive policies is critical for creating safe health facilities for patients. Contribution: This study provides evidence to assist policymakers, educators, and health administrators in developing sustainable policies that maintain professional ethics and comply with the constitutional requirement for equitable healthcare. It underscores the need for policy reforms, better resourcing, and supportive environments to strengthen nurses’ capacity for rights-based, ethical, and patient-centred care.

Introduction: Infertility continues to be a major public health issue with deep social and psychological effects, particularly in low- and middle-income environments. The purpose of this study was to evaluate the knowledge, attitudes, and practices of men and women around infertility in the City of Tshwane, Pretoria, South Africa. Methods: This descriptive quantitative study surveyed 390 participants in Tshwane District primary healthcare settings using a self-administered questionnaire and stratified sampling. Results: The study found that most participants had a good understanding of infertility causes, with 67.4% identifying menstrual cycle irregularities as a potential factor for female infertility and 64.4% recognizing semen abnormalities as a cause for male infertility. However, there were some misconceptions identified, such as 30.5% of people believed that infertility was more common in women than in men, and 69.2% of individuals considered it a disability. With 79.5% of respondents identifying infertility as a medical problem, attitudes regarding it were largely positive. The majority—90.7% of the participants—were open to changes in lifestyle and assisted reproductive methods, such as IVF. Gender differences in coping mechanisms were found in that 79.2% of males favoured traditional medicine for the treatment of infertility, while 90% of the women preferred spiritual or religious practices. Discussion: According to this study, both men and women in Tshwane had favourable views and good knowledge regarding infertility. Though there were some misunderstandings, most participants were aware of some causes of infertility. Openness to medical treatments was noted in the willingness to embrace assisted reproduction and lifestyle modifications. Conclusion: The study found that while men and women had knowledge and positive attitudes toward infertility. However, misconceptions, such as viewing infertility as a disability and as a woman’s problem, persisted. Attitudes towards infertility from both genders were mainly positive, with significant support for lifestyle modifications and assisted reproduction technology. Gender differences in coping mechanisms were evident, with males choosing traditional medicine while women favoured religious methods. To increase awareness and lessen the stigma associated with infertility, the study stressed the need for gender-sensitive, culturally relevant health educational initiatives to improve awareness and address misconceptions.

Midwives play a pivotal role in ensuring safe childbirth, particularly in the management of obstetric emergencies and complications (EmONC). Continuous Professional Development (CPD) programs are essential to keep midwives updated with the latest skills and knowledge, ensuring high-quality maternal care. The study aimed to map and synthesize evidence on continuing professional development for midwives optimising management of obstetric emergencies and complications to reveal evidence to address the knowledge gap and implementation of policy. This scoping review was guided by the adapted version of Arksey and O’Malley methodological framework (2005). We searched databases from 2013 to 2023: PubMed, SCOPUS, Web of Science, EBSCOhost (CINAHL, MEDLINE and Academic search): and ProQuest central. The studies were appraised using mixed methods appraisal tool (MMAT) version 2018. Content analysis and synthesis of the findings were conducted using Nvivo 12. Of the 752 articles identified through database searching, 31 articles met the inclusion criteria and reported according to the Preferred reporting items for systematic reviews and meta-analyses extension for scoping review (PRISMA-ScR) checklist. After data extraction, content analysis yielded the following 4 major themes: Types of CPD training programs, Effectiveness of CPD on management of obstetric emergencies, Barriers/Challenges with lack of implementation of CPD programs and Suggestion for implementation of CPD programs. The findings revealed the significance of CPD programs in equipping midwives with the necessary skills and knowledge to handle obstetric emergencies effectively. The program can be offered in various approaches including simulation-based training, technology-based simulation, online modules, workshops, and interdisciplinary/interprofessional learning sessions, have shown to be effective. Each method offers unique advantages, such as hands-on practice in simulations and flexibility in online learning with smart applications such as SAFE delivery applications. Research Ethics reference #322/2023, date of registration: 14/02/2024.