Postgraduate Diploma in Midwifery

Purpose

The purpose of the Postgraduate Diploma in Midwifery is to provide midwives working in the maternity and neonatal nursery areas with advanced knowledge and specialised skills which will assist in providing specialised midwifery and neonatal nursing care to individuals with high risk and life-threatening conditions. The qualification fosters innovation and creativity in specialist midwives producing learners who can effectively use analytical and problem-solving skills to influence clinical practice, service delivery and effect change as midwife specialists and neonatal nurse leaders.

Upon completion of this qualification, qualifying learners will be able to

• Function with advanced clinical competencies within maternal and neonatal nursing, enhancing their ability to evaluate and apply theoretical knowledge and contemporary evidence to their own clinical practice.
• Function as leaders, who are clinically focused, service-oriented, autonomous and innovative, able to render specialised midwifery care and in a continuum as determined by the appropriate legislative framework.
• Lead, conduct, disseminate and utilise research both inter and intra- professional in informing holistic based obstetric, midwifery and neonatal care to advance the practice of midwifery and provide evidence-based holistic care.
• Utilize a scientific approach to collaboratively assess client needs, formulate an accurate evidence-informed diagnosis.
• Initiate, develop and discontinue therapeutic relationships using a range of advanced communication and interpersonal skills respecting the boundaries between health care users and self, including their points of view and that of the members of the multidisciplinary health care team.
• Continuously reflect on the self and staff competence and keeps self, staff and health care users up to date with current healthcare issues, technology and health care trends in the dynamic environment using a range of supportive strategies.
• Assume leadership and management responsibilities and evaluate the implications of current health care policies on care and care provision.

Rationale

The World Health Organization (WHO), in 2015, reported progress by many countries towards achieving the now outdated Millennium Development Goals (MDGs). Maternal mortality rates, however, represented and continue to represent one of the biggest healthcare challenges facing low and middle-income countries (LMIC) in Sub-Saharan Africa (SSA), where the majority of maternal and child deaths occur. Maternal mortality rates in LMIC are as much as twenty times higher than in developed countries. In South Africa, midwifery is under the spotlight due to persistently high rates of maternal and perinatal morbidity and mortality and maternity-related litigations, despite the South African government's concerted collaborative efforts to reduce this burden.

As an example, maternal and perinatal mortality remains a major health challenge with a high maternal mortality rate. South Africa remains far from meeting its commitment to the third Sustainable Development Goal (SDG), hence it has adopted the National Developmental Programme (NDP) 2030 vision, which, in collaboration with SDGs, aims to cut maternal mortality to less than 70 per 100,000 births and to reduce neonatal mortality to less than 12 per 1000 live births. To attain the above ambitious 2030 SDGs, then substantial improvements need to be achieved in LMIC, especially in SSA. The persistently high burden of maternal mortality and morbidity, and the rapidly changing healthcare system in South Africa, which is characterised by complex cases, requires autonomous specialist midwives, critical thinkers able to analyze and interpret client's cues, question and weigh the evidence and make an informed judgement and clinical decisions.

The Strategic Plan for Nursing Education, training and practice 2012- 2016, states that the changing dynamics of the South African Health Sector requires a Clinical Midwife Specialist to meet the increasingly complex demands of caring for high-risk women during pregnancy, labour, and the puerperium. The increased numbers of maternal, perinatal and neonatal mortality rates in the country have also led to complex demands on midwives to utilize rapid meta-cognitive problem-solving skills in managing concrete and abstract obstetrical emergencies. Pre-registration midwives are exposed to the complexity of specialized midwifery practice, however, they lack theoretical knowledge and specialized skills which are needed to be clinical specialists.

Primary Health Care Engineering, introduced recently in the country demands a specialist in Midwifery to participate in the specialist teams. At the same time, the Department of Education is changing to redress the inequalities of the past especially in terms of access. SANC has therefore been compelled to change regulations to transform the education of midwives towards a clinical speciality module providing graduates to choose a specialist career path in Midwifery. Learners pursuing this path will earn the qualification of a Clinical Midwife Specialist.

Recognition of Prior Learning (RPL)

This qualification may be achieved in part or in whole through the Recognition of Prior Learning, which includes formal, informal, and non-formal learning and work experience. The Recognition of Prior Learning (RPL) assessment process involves the identification, mediation, assessment and acknowledgement of knowledge and skills obtained through informal and non-formal learning. RPL is applied in terms of the policy and criteria of the institution. The necessary documentary evidence will have to be provided and a formal RPL process will be followed. The institution will apply in this qualification the RPL for both access and credits in line with the National Policy and Criteria for the Implementation of RPL (Amended in March 2019).

RPL for Access

Learners who do not meet the minimum entry requirements of the required qualification may be considered for RPL. There are two options:

• Advanced Standing, in which case the minimum entry requirements are waived by the admitting institution based on evidence of prior learning, work experience or any other relevant circumstances that may apply to an individual learner. No portfolio is required.

OR

• Applicants may provide evidence in the form of a portfolio that demonstrates that the applicant has acquired sufficient relevant knowledge, skills, and competencies to be able to reasonably meet the expectations for learning demanded by the qualification for which they are seeking access.
• In instances where RPL is applied for the purposes of access, no credits will be awarded for any previous learning. However, the candidate may choose the option of being assessed for credit.

RPL for credits

Learners who do meet the necessary entry requirements for admission to a qualification may be awarded some or all the credits towards the qualification. There are two possibilities:

• Learners may apply for RPL to be exempted from a module or some modules by providing sufficient evidence in the form of a portfolio that demonstrates that a level of competency, equivalent to the learning outcomes of the module or modules, has been achieved. Credits will be awarded for such modules.

OR

• Learners may apply for RPL to be awarded all the credits required for the qualification. Sufficient evidence must be provided that demonstrates a level of competency equivalent to all the learning outcomes of the qualification.

Entry Requirements

The minimum entry requirement for this qualification is

• Bachelor's Degree in the related field, NQF Level 7.

Or

• Advanced Diploma in Midwifery, NQF Level 7.

This qualification consists of the following compulsory modules at National Qualifications Framework Level 8 totalling 128 Credits.

Compulsory Modules, Level 8,128 Credits

• Midwifery: Theory, 16 Credits.
• Midwifery: Practice, 32 Credits.
• Nursing Research Methods, 16 Credits.
• Neonatal Nursing: Theory, 8 Credits.
• Neonatal Nursing: Practice, 24 Credits.
• Philosophical perspectives in Nursing, 16 Credits.
• Managing Learning Organisations in Health Care, 16 Credits.

1. Demonstrate increased responsibility for own professional and ethical judgment, actions, outcomes of care and continued competence in accordance with legislation, relevant code of ethics and competency framework prescribed by SANC and associated health structures.
2. Lead, conduct, disseminate and utilise research both inter and intra- professional in informing holistic based obstetric, midwifery and neonatal care to advance the practice of midwifery and provide evidence-based holistic care.
3. Utilize a scientific approach to collaboratively assess client needs, formulate an accurate evidence-informed diagnosis.
4. Initiate, develop and discontinue therapeutic relationships using a range of advanced communication and interpersonal skills respecting the boundaries between health care users and self, including their points of view and that of the members of the multidisciplinary health care team.
5. Continuously reflect on the self and staff competence and keeps self, staff and health care users up to date with current healthcare issues, technology and health care trends in the dynamic environment using a range of supportive strategies.
6. Assume leadership and management responsibilities and evaluate the implications of current health care policies on care and care provision.

Associated Assessment Criteria for Exit Level Outcome 1

• Use Critical decision-making and moral reasoning models to guide clinical practice and resolve professional-ethical dilemmas within Midwifery and Neonatal care.
• Apply the relevant latest legislation, policies, protocols, regulations, guidelines, directives and applicable ethics regarding Midwifery and Neonatal care in practice.
• The professional/ ethical legal frameworks guide the Midwife Specialist practice.
• Practice and facilitate advocacy for the rights of women, partners or husbands, children and families in their best interests.
• Interpret and apply ethical codes, professional accountability, responsibility, confidentiality and standards for the practice of Midwifery and Neonatal nursing consistently and correctly.

Associated Assessment Criteria for Exit Level Outcome 2

• Demonstrate academic writing skills in research reports.
• Appraise research articles in the field of Midwifery and neonatal healthcare through the application of basic knowledge of research methodology.
• Differentiate qualitative, quantitative and mixed-method research designs accurately differentiate.
• Integrate evidence-based practice of research findings for safe, effective, and efficient practice.

Associated Assessment Criteria for Exit Level Outcome 3

• Promote health outcomes through the demonstration of knowledge of midwifery and neonatal specialist care of patients in a variety of clinical settings.
• Interpret and use epidemiological data on mother-and-child health to plan a community awareness programme/campaign.
• Use biomedical, pharmacology and psychosocial sciences to explain the interpretation of health assessment findings and management of conditions affecting the pregnant woman and neonates.
• Compare and debate best available evidence, theories or models on mother-and-child health.
• Identify and debate legislation that applies to mother-and-child health, and communicate the recommendations to authorities.
• Debate the influence of the social, political, cultural and economic developments within the country on the provision of Midwifery and Neonatal nursing care are debated and communicate recommendations to authorities with the ultimate goal of improving midwifery and neonatal practice.
• Interpret subjective and objective assessment findings, results from investigations and laboratory results in order to make a nursing diagnosis.
• Base comprehensive individual, people-centred, inter-professional midwifery and neonatal specialist treatment plans on assessment findings and standardised national and contextually appropriate guidelines.
• Explain and debate the rationale and safety measures of technology used in assessing and treating pregnant women and neonates.
• Explore and debate care pathways and the referral system.
• Use medico-legal standards (national core standards) to audit files of pregnant women and neonates.
• Evaluate the accuracy of data on mother-and-child health care.

Associated Assessment Criteria for Exit Level Outcome 4

• Communicate effectively with other members of the multidisciplinary team.
• Sharing information in accordance with legal, professional, and regulatory requirements.
• Apply values underpinning collaboration and works effectively with the members of the multidisciplinary health team in the provision of holistic care to clients.

Associated Assessment Criteria for Exit Level Outcome 5

• Apply precepting and mentoring processes to develop self and peers.
• Develop thinking/reasoning processes of self and others through facilitation of learning.
• Apply learning theories in own development and the development of others.
• Create a positive learning environment by supporting peers and novices.
• Establish and use academic networks to sustain personal development.

Associated Assessment Criteria for Exit Level Outcome 6

• Manage midwifery and neonatal health services according to medico-legal norms, practices, and standards within an inter-professional team.
• Demonstrate appropriate leadership styles within the midwifery and neonatal inter-professional team.
• Create and document shared decision-making opportunities regarding midwifery and neonatal healthcare services.
• Access and use benchmarks and best practices to develop indicators for quality and cost-effectiveness in midwifery and neonatal nursing.
• Mobilise and utilise resources to optimize midwifery and neonatal nursing care.
• Analyse and optimise care pathways and referral system.
• Coordinate the activities of the inter-professional team within midwifery and neonatal nursing care.
• Use morbidity and mortality data on midwifery and neonatal care for decision-making.
• Contribute significantly to the formulation of policies regarding the mother and child, and demonstrate the development of midwifery and neonatal Nursing.
• Participate in efforts to influence health care policy on behalf of health care users and the profession mainly management/operational tools like protocols, standards, logarithms, etc.