Measuring the importance of labour support practice for mothers and nurses and midwives at public health facilities in Rwanda
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Date
2020
Authors
Uwimana, Marie Chantal
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Abstract
Background: The need to support women during labour and delivery at health facilities is
important for a positive birth experience and for improving the quality of maternal and
neonatal care. Provision of labour support offered by nurses and midwives assist labouring
women to cope with the process of childbirth. Little is known about the provision and the
measurement of labour support practices in developing countries including Rwanda.
Aim: The aim of this study is to establish the current state of the importance of labour
support practices for mothers and nurses and midwives at public health facilities in Rwanda.
Methodology: A descriptive quantitative and cross-sectional design was employed in this
study. The study began with a scoping review followed by the development of a labour
support tool, then a survey was conducted using the labour support questionnaire with closed
and open-ended questions among 648 women in postnatal wards and 154 nurses and
midwives working in labour and delivery wards at public health facilities located in Kigali
City, Rwanda.
Findings: Best practices of labour support including emotional support, physical support,
information and advice and advocacy are implemented in developing countries. The
quantitative data revealed that most nurses and midwives were relatively young (<40 years
old). Most mothers had only obtained a primary level of education. Nurses and midwives and
mothers valued and ranked high the importance of professional support and communication
during the childbirth process. Both participant groups ranked the comfort and emotional
support as less important. Mothers with primary education attributed a low ranking to the
importance of professional support. The majority of nurses and midwives who had spent
more than 10 years in labour and delivery wards indicated a limited importance for comfort
support. Mothers and nurses and midwives reported that limited infrastructure, shortage of
staff and equipment and a lack of awareness of labour support influenced negatively the
implementation of labour support practices.
Conclusion: Though nurses, midwives and mothers value and rank highly the importance of
professional support and communication during the childbirth process, the effective
implementation of labour support practice is often challenged by constrained resources. The
recommendations are formulated with regard to nursing practice, management, education,
research and policy.
Description
A thesis submitted in fulfilment of the requirements for the degree of
Doctor of Philosophy in Nursing to the Faculty of Health Sciences, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, 2020