Advanced Diploma in Midwifery

Purpose

The purpose of the qualification is to produce competent, independent and critical thinking midwives. The learners will provide scientific, safe and comprehensive quality midwifery care to individuals, families and communities. The midwifery care will be within the legal and ethical framework. Also, within the multidisciplinary teams and reengineered Public Health Care (PHC) system.

The qualification aims to

• Produce competent, independent and critical thinking midwives who will function within a wide range of health care levels, particularly in the midwifery health care settings.
• Produce a competent midwife equipped with relevant skills to address a variety of National health priorities with special reference to preventing mother to child transmission of HIV, NIMART, TB management and essential Steps in Managing Obstetric Emergency and BANC.
• Provide midwives with a wide range of skills, knowledge and attitudes that will enable them to make a meaningful and sustained contribution to midwifery services.
• Equip midwives with a developed sense of equity, justice and service ethics that will ensure that they work in a responsible and accountable manner irrespective of their chosen workplace.
• Offer a wide range of transferable skills for application in other professions, disciplines and general life. These include:

> A methodical solution-based approach to problem-solving.

> Empowerment - based approach to the development of self and others.

> Competence in written and oral communication.

> Capacity to assess and implement midwifery practice and other policies.

> Ability to plan, implement and manage projects of a varied nature.

• Equip the midwives with leadership and advocacy skills in the delivery of integrated and comprehensive midwifery and neonatal care.
• Equip midwives to provide a scientific, safe and comprehensive quality care within the ethical-legal framework.
• Research capacity.

Rationale

One of the goals of the National Development Plan (NDP) 2030 vision is to reduce maternally, infant and child mortality significantly. The NDP will be achievable through the following initiatives, namely,

• Taking Essential Steps in Managing Obstetric Emergency (ESMOE) training for doctors and midwives,
• Intensifying midwifery education and training,
• Strengthening family planning services,
• Establishing maternity waiting homes,
• Establishing Kangaroo Mother Care facilities (Department of Health Strategic Plan 2015//16- 2019/20).

According to the strategic plan for nursing education, training and practice 2012/2016, the changing dynamics of the National Health Care System requires a clinical focus, service-oriented independent practitioner. This practice will meet the increasing quadruple burden of diseases, which puts a woman and new-born at risk during pregnancy labour and puerperium.

Kwa Zulu Natal had the highest percentage of maternal deaths at 23% in 2013; this has increased the demand for midwives to address this challenge.

On successful completion, learners will be able to register with the South African Nursing Council as midwives. These midwives will function as independent professionals in rendering midwifery and neonatal care within the ethical-legal framework and national guidelines and in partnership with the PHC Re-engineering Multidisciplinary Health Team.

Recognition of Prior Learning (RPL)

The qualification will provides RPL for access at the beginning of the qualification for learners who were unsuccessful in the following legacy programmes namely:

a. Course leading to registration as a Nurse (General, Psychiatric and Community) and Midwife (Notice No. R.425 of 22 February 1985, as amended)

b. Course leading to registration as a Midwife (Notice No. R254 of 14 February 1975 as amended)

1.1 On condition that they have completed the South African Nursing Council Midwifery Register

1.1.1 The learner will be allowed to access the qualification.

1.1.2 The learner will be granted practical credits.

1.1.3 Given the duration of time and given that the practical experience may not be current these learners will still be expected to complete the Work Integrated Learning which is 504 notional hours.

1. RPL for learners with only informal and non- formal (experiential learning) will be required to submit a Portfolio of Evidence of competence in accordance with the South African Nursing Council Midwifery Registers which stipulates the following Midwifery practical skill:

• Supervision of pregnant women 30
• Assessment and care of Ante Natal patients with abnormal conditions 15
• Internal examinations (per vaginal) x 15
• Assessment and care of women during the first stage of labour x15
• Normal Vaginal deliveries minimum 15
• Management of third stage (delivery of the placenta) x15
• Care of the woman immediately after delivery x15
• Perform and Repair of the Episiotomy x3
• Management of mother and baby post-delivery x15
• Administration of local anaesthesia during repair of the Episiotomy x3
• Immediate care of a normal and a sick neonate x10

The portfolio of Evidence will be evaluated by a SANC registered Assessor on condition that the Portfolio of Evidence meets ALL the above requirement;

• The learner will be allowed to access the qualification.
• The learner will be granted practical credits.
• In addition, these learners will still be expected to complete the Work Integrated Learning which is 504 notional hours.

There will be no RPL for advanced standing for this qualification.

Entry Requirements

The minimum entry requirement for this qualification is

• Diploma in Nursing, NQF Level 6.

This qualification consists of compulsory modules at NQF Level 7 totalling 120 Credits.

• Ethical legal and Professional practice in Midwifery, 8 Credits.
• Foundations of Midwifery and Neonatal Care, 24 Credits.
• Integrated Management of HIV, TB and STI's in Midwifery, 24 Credits.
• Management of High-Risk Midwifery and Neonate Care, 24 Credits.
• Management of Obstetric and Neonatal Emergencies, 24 Credits.
• Management of an Obstetric Unit, 16 Credits.

1. Apply specific knowledge of bio-natural, pharmacology and social sciences in midwifery using an integrated approach.
2. Provide safe and quality midwifery and neonatal care in a scientific, integrated and evidence-based approach in all health care settings.
3. Improve the quality of midwifery and neonatal care through an analytical, reflective and problem-solving approach.
4. Improve the quality of midwifery and neonatal care through an analytical, reflective and problem-solving approach.
5. Effectively manage a midwifery unit through appropriate clinical governance strategy.

The following Associated Assessment Criteria will assess the Exit Level Outcomes in an integrated manner.

• Illustrate problem-solving skills by utilising scientific information to improve the quality of midwifery practice.
• Initiate, maintain and utilise methods of enquiry to monitor the quality of care.
• Participate in the development, review and implementation of midwifery quality improvement plan.
• Utilise research findings to inform and improve the standards of midwifery practice.
• Demonstrate the ability to effectively apply knowledge from the biological sciences in solving familiar problems/needs of individuals of all age groups in a variety of health care settings.
• Demonstrate a sound knowledge of the scientific principles of preventive, promotive, curative and rehabilitative health in providing care to individuals with health needs/problems.
• Select and apply knowledge gained from Pharmacology in solving well defined medical and surgical problems of individuals of all age groups.
• Use knowledge and experience to offer suggestions for solving health problems at a community level.
• Demonstrate knowledge and understanding of the normal development of a person within a society and how this can influence health, illness and health care delivery.
• Demonstrate an understanding of the value of communities of practice and clinical leadership management principals.
• Access benchmarks and best practices and develop and utilise indicators in Midwifery care.
• Provide and develop indicators to account for the quality and cost-effectiveness of Midwifery care.
• Develop unit philosophy, vision, mission, goals, policies and procedures for midwifery care.
• Manage diversity and collaborate with all stakeholders within the midwifery context.
• Demonstrate knowledge of applicable ethics, professional practice and legal aspects during midwifery practice.
• Practice and facilitate advocacy for the rights of women, children and their families.
• Demonstrate accountability and responsibility for own professional acts and omissions within the relevant legal and ethical parameter.
• Promote equality within rights regardless of sex, race, religion.
• Demonstrate efficiency in gathering, analysis synthesis and evaluation of health-related information using applied research methods.
• Use research findings in nursing and midwifery practice.
• Coherently and effectively communicate for professional and academic purposes.
• Demonstrate ability to communicate effectively with the client taking into consideration cultural variations that may affect communication.
• Demonstrate efficiency in gathering and presenting health-related information using appropriate methods and computer applications.
• Effectively apply scientific principles and appropriate technology to provide comprehensive care in meeting the needs of individuals, families, groups and communities of all age groups in a variety of health care settings.
• Demonstrate a sound understanding of the comprehensive health delivery system and to appreciate the place of nursing as a practice within a wider social, cultural, and political context of health care delivery.
• Demonstrate scientific knowledge of the discipline of nursing by applying ethical, moral, legal and professional principles in his/her practice.
• Learn by participating in groups and experientially in clinical settings.
• Use technology effectively as additional sources of information.
• Apply knowledge and skills gained in different contexts, both personal and professional in real and simulated contexts.
• Demonstrate evidence of effective study skills.
• Demonstrate an awareness of the impact of his/her background, act sensitive to and display tolerance of other peoples' diversity, cultures and opinions.
• Apply knowledge and skills gained from interacting with clients and multidisciplinary team members in culturally diverse contexts.
• Integrate scientific knowledge in the provision of care to individual, families, groups and communities in dealing with potential and actual health and health-related problems.
• Demonstrate a personal and professional sense of work ethics and self-directed learning in his/her development.
• Handle their values, convictions and feelings when interacting with learners in clinical placements and later in their professional lives.
• Apply the Body Mind and Soul approach in all her care provisions with confidence.
• Collect information about the patient relating to body, mind and spirit health status.
• Discuss with multidisciplinary about the health care users holistic care needs and interventions.
• Provide holistic care and evaluate it.

Integrated Assessment

Integrated Assessment evaluates the learners' ability to integrate and apply knowledge. The knowledge gained is from fundamental modules during the assessment of core modules; for example, knowledge from Human Biology will be fundamental to Fundamental Nursing Science.

Formative assessment

The purpose of formative assessment is to provide regular feedback to the learners on their progress. Continuous assessment will be afforded by the approach to teaching and learning adopted, which is the case-based method for most core modules. In this approach, learners will be required to prepare and present case studies for class discussion. Formative assessment will also be done in the form of tests, projects, journals, assignments and others, as reflected in detailed module descriptors. In line with the institution's policy on assessment, this form of assessment will constitute 40% of the total assessment.

Summative assessment

The purpose of summative assessment is to judge the learners' performance for purposes of promotion or failure. This assessment will form 60% of the total assessment. Summative assessment will take the form of written theory papers, clinical examinations.