Latest News Archive

Please select Category, Year, and then Month to display items
Previous Archive
20 December 2021 | Story Elsabé Brits
Dr Elgonda Bekker, from the University of the Free State (UFS), completed her doctoral degree in nursing in 2020, with a practical, transformative thesis to improve the education of midwives in the country.

Midwives who are properly trained and acknowledged for their skill and experience do not only save lives but make a huge contribution to maternal health in South Africa. However, there is a dire need for professional midwives and competent educators. 

Dr Elgonda Bekker, from the University of the Free State (UFS), completed her doctoral degree in nursing in 2020, with the title: Competencies of South African midwifery educators: a transformative framework. It is a practical, transformative thesis to improve the education of midwives in the country. Sadly, just months after she received her degree she passed away. Yet, her colleagues at the School of Nursing at the UFS continue to build on the foundation she laid.  

Too much too soon, too little too late 

The World Health Organisation (WHO) states that 10-15% of births may need intervention through caesarean section. A recent analysis, however, found that private hospitals had a caesarean section rate of 73.6%, compared to 26% in the public sector.

Although the public sector rate is higher than the WHO target, the private sector rate is not justifiable, Bekker writes. The case fatality rate for mothers who died after a caesarean section had been performed showed an increase. That is one of the statements indicating that not all medical interventions are of benefit to mothers.

A focus on too much too soon or too little too late in the Lancet series on midwifery of 2014 indicated the need for better-quality care. In South Africa both manifest because of the disparity between private and public healthcare. According to Bekker’s research, the high caesarean section rate in the private sector is a classic example of over-medicalisation of obstetric care, whereas the public healthcare system follows a midwifery-led model of care.

“Midwives are a vital solution to correct this disparity. Competent midwives, educated to standards, can prevent interventions without indication, provide service in rural settings and advocate for the rights of the childbearing family,” she wrote.

Midwifery is a disempowered profession 

Winnie Moroa Motlolometsi, a midwifery educator, explains that professional nurses in the country have a dual registration with the South African Nursing Council as a nurse-midwife. This leads to many qualified midwives not necessarily practising as midwives. It is therefore very difficult to calculate the number of practising midwives. 

Furthermore, the conflation of nursing and midwifery requires training as a generalist practitioner. Depending on the institution where they are trained, professional nurses may or may not comply with the International Confederation of Midwives’ Global Standards for education and regulation of the midwifery profession. 

Nevertheless, according to Dr Bekker’s research, midwifery is a disempowered profession, because the global guiding documents are neither considered by the regulatory authority nor the National Department of Health. There is a triple gap for competencies, coverage, and access: 

  • Insufficient numbers of competent midwives 

  • .. who can cover maternal health services 

  •  …who render services that address the needs of women 

There is a dire need for competent midwives in the country, but the predicament is that whilst midwifery educators are qualified, they are not necessarily clinical specialists, which ultimately jeopardises the quality of maternal healthcare. 

What was also clear from Bekker’s research is that although South Africa has a progressive constitution, gender equality has not materialised on grassroots level. Violence is ever present. Women are viewed as weaker, vulnerable, and less suited for the workplace. Nonconformity to sexual gender norms, based on cultural or religious bias, creates conflict for some women.  

Dr Deidre van Jaarsveldt, senior lecturer in the School of Nursing at the UFS, said Bekker’s study highlighted that feminism is a strengthening agency for women. In this study it was important to frame the context of midwifery as a disempowered, woman-led profession, caring for women who are still finding themselves in a society where there is gender inequality. 

The research indicated that there were many challenges: 

  • Lack of autonomy for midwives 

  • Non-compliance with the global midwifery standards 

  • Conflation of nursing and midwifery 

  • Midwifery regulated by non-midwives 

  • Lack of direct entry into midwifery education in the country 

  • High litigation in maternal and child healthcare – there is fearfulness among practitioners and reluctance to work within the midwifery profession 

In practice it is difficult to distinguish midwifery specialists from nurses who are practising as generalists and are expected to offer maternal healthcare services. If something goes wrong, the midwifery profession is held accountable, but practising midwives were not necessarily involved. 

Reproductive, Maternal, Newborn and Child Health Hub 

There is a dire need for midwifery to become an autonomous profession guided by global standards. Membership should be based on advanced qualifications, which strengthen midwifery as a speciality. This can only be attained through education and maintained by a regulatory body, as well as the de-conflation of midwifery from nursing. When this happens, midwives will know who the actual midwives are and be able to hold one another accountable, Motlolometsi adds. 

Dr Bekker advocated for the “decolonising” of midwifery, which means restoring the knowledge to the profession. To allow midwives to receive quality education, midwifery should become an independent profession that is guided by global standards and regulated by midwives.  

Van Jaarsveldt says the School of Nursing at the UFS endeavours to offer quality midwifery education. Students learn in a high-tech simulated learning environment where they can become competent before working with actual mothers and babies. The educators are clinical experts, supported by a team of midwifery practitioners who act as preceptors for the students. 

Before her untimely death, Dr Bekker started establishing a Reproductive, Maternal, Newborn and Child Health Hub in the Faculty of Health Sciences, which is continuing under the leadership of Dr Cynthia Spies, supported by a team of interprofessional experts.  

“Through research and continuous improvement of education and practice, this group of professionals envisions optimising and strengthening reproductive, maternal, newborn, and child health competencies so that current maternal and child morbidity and mortality trends can improve resulting in surviving and thriving childrearing families.  

“The goal is to develop partnerships and opportunities for collaboration and research with colleagues in healthcare disciplines and to extend beyond healthcare to include innovative interdisciplinary partnerships,” says Spies. The objectives include:

  • Practice development with implementation of evidence-based practice and positive experience of the childbirth and child health continuum; 
  • Clinical competency development through training and the development of short learning programmes; 
  • Clinical research that addresses the current reproductive, maternal, neonatal and child health mortality, morbidity and health issues in central South Africa.

News Archive

UFS produces an inspirational Summer Graduation
2016-12-12

Description: Dr Ferial Haffajee summer graduation Tags: Dr Ferial Haffajee summer graduation 

Dr Ferial Haffajee, editor-at-large at The Huffington
Post SA, who was conferred with an honorary doctorate,
and Dr Khotso Mokhele, the Chancellor of the
University of the Free State at this year’s Summer Graduation.
Photo: Eugene Seegers

“A graduation ceremony epitomises every student’s academic dream and pursuit, and allows you to look back as you enter the professional career of your choice.”

These were the words of guest speaker Dr Mafu Rakometsi, Chief Executive Officer of Umalusi, that resonated through the Callie Human Centre at this year’s Summer Graduation on the Bloemfontein Campus. He mentioned that today graduates would look back at a journey that started with hesitant steps, and despite all their ups and downs, they had managed to make it this far.

During the afternoon session, Prof Lis Lange, Vice-Rector: Academic, at the University of the Free State (UFS), said that graduations were always an occasion for celebration and this year, there were two reasons for these celebrations.

 “The first is simply that we made it through a difficult 2016 and the secondly because we are celebrating two crucial professions that will attribute to the well-being of this country, namely teachers and health practitioners.”

Meaningful graduation ceremony for Ferial Haffajee

This year, the UFS had the privilege and honour to confer editor-at-large at The Huffington Post SA, Ferial Haffajee, with an honorary doctorate in the Faculty of the Humanities.

Speaking after the graduation ceremony, Dr Haffajee said, “It was really, really meaningful for me, because I’ve never been able to graduate. When I finished university, it was during the struggle against apartheid, so we didn’t graduate. It was a wonderful day and wonderful to see the role that young people are playing on this campus.”

“Dr Ferial Haffajee has made a significant contribution to press freedom in South Africa. She is known both nationally and internationally for the work she has done and therefore it is an honour to welcome her as a Kovsie. She is one of the people who represent the values of the UFS. We are proud of her and we wish her great success,” said Prof Milagros Rivera, Head: Department of Communication Science and acting Dean of the Faculty of the Humanities at the UFS.

Description: Summer graduation 2016 general photo Tags: Summer graduation 2016 general photo 

Photo: Johann Roux

Inspiration drawn from graduation ceremonies

During his address, Dr Khotso Mokhele, the Chancellor of the UFS, made special mention of many that inspired him at the graduation ceremonies.

His inspirations included Dr Ambrotius Swartbooi, who suffered a spinal injury from a near-fatal car accident which left him paralysed and a quadriplegic, yet who still managed to receive his doctorate; Setsoane Ntseki, a matriculant with poise and an incredible voice, who delivered the song item; Judge Ian van der Merwe, Chairperson of the Council at the UFS and a close friend of Dr Mokhele, with whom he worked for many years; as well Dr Haffajee, a trail-blazer that many look up to.

Damian Viviers was recognised as one of the youngest PhD graduates in the Faculty of Law, where he received a PhD in Mercantile Law. He is a research fellow in the Department of Mercantile Law, and was recently appointed as candidate attorney in the commercial department at Phatshoane Henney Attorneys.

In closing, his message to the class of 2016 was simple, that even though the world and our country may find itself in an odd space now, the graduates needed to remember that even though they would become leaders, there was always something bigger than themselves.

“Go out there and do us proud. Come back and plough back into this institution not only with your money, but your skills and time too.”

We use cookies to make interactions with our websites and services easy and meaningful. To better understand how they are used, read more about the UFS cookie policy. By continuing to use this site you are giving us your consent to do this.

Accept