Postgraduate Diploma in Midwifery

The purpose of the Postgraduate Diploma in Midwifery is to strengthen and deepen the learner's knowledge and expertise in nursing and midwifery as a speciality. It will enable the Midwife Specialists to engage in their respective specialist areas of practice with in-depth knowledge, skills, attitudes, and values to enhance professional independence and optimum health outcomes. This includes preventing disease, injury and complications. It also entails screening, appropriate management and prompt referral of patients with specific and complex problems in all clinical settings. The qualification further equips the learner with facilitation of teaching and learning including management skills at all levels of practice.

The qualification will

• Produce competent professional specialist midwife practitioners within a wide range of health service settings.
• Produce competent, independent, and critically thinking Mmidwifery Specialists within a wide range of midwifery services and skills thereby contributing to meaningful and sustained Specialist Midwifery practice within a wide range of health service settings.
• Provide postgraduates with a wide range of skills, knowledge and attributes that will enable them to make a meaningful and sustained contribution to health services nationally and internationally.
• Equip postgraduates with a developed sense of equality, 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 including.

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

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

• Competence in written and oral communication.
• Capacity to assess and implement health and other policies.
• Ability to plan implement and manage projects of a varied nature research capacity.

Rationale

The South African Healthcare System has adopted a primary healthcare approach which is nurse-led in-depth acquisition of knowledge in a specialist field, discipline and/or practice.

In the interest of the right to access health enshrined in the Constitution of South Africa (Act No. 108 of 1996), the South African Healthcare System is embarking on the National Health Insurance (NHI) to promote access to quality, essential healthcare services and access to safe effective quality and affordable essential medicines and vaccines for all. This happens when there is an outcry that there is an increase in the burden of diseases from the quadruple diseases including communicable diseases predominantly HIV and AIDS and TB, non-communicable diseases such as Hypertension, Diabetes Mellitus, and Cancer, Perinatal and maternal morbidities and injury-related disorders.

There is a continuing shortage of doctors who either give attention to the public sector for their private practice or are specialists in private hospitals. The Nurse Specialist or Midwife Specialist complements the remaining medical fraternity rather than replacing them. Furthermore, the NHI has necessitated a focus on quality to ensure value for money which the knowledgeable Midwife Specialist can drive. This qualification will produce a Midwife Specialist with the competencies required to respond to the reproductive, maternal, neonatal, women and child health needs of the country.

While the seventeen (17) Sustainable Development Goals promote inter-sectoral collaboration, the Nurse Specialist and Midwife Specialist are appropriately positioned to ensure healthy lives and promote the well-being of all ages through their active engagement in promotive, preventive, curative and developmental health services which are components of the Primary Health Care. The South African Nursing Council (SANC) realigned the nursing qualifications to the changes in the NQF Act, 67 of 2008. New nursing education standards and curriculum guidelines have been published. The scope of practice of the envisaged new nursing cadres has been incorporated into this qualification.

On successful completion of the qualification, the graduate will be registered as a Midwife Specialist with the SANC to practice as defined by the Nursing Act No. 33 of 2005.

The institution's recognition of prior learning processes is used to increase access to qualifications by individuals through experience at the workplace, experiences through daily life or credit-bearing exemption. In the case of postgraduate diploma programmes experience must be aligned to nursing and midwifery as well as to the speciality of choice.

RPL for access

• Recognition of Prior Learning may be considered where a learner enters a qualification through non-traditional means, e.g., learners who do not meet the academic requirements for admission into a qualification may access that qualification based on their work experience.
• Learners should provide evidence in the form of a portfolio of evidence detailing their experience, or they may challenge an examination on that module that they require recognition on. The outcome may determine admission or an award of credits toward the module.

RPL for exemption from modules

Learners can enter a qualification by exemption from the module/s that have been completed.

• The learner may not be exempted from more than 50% of the prescribed credits towards obtaining the qualification.

Entry Requirements

The minimum entry requirement for this qualification is

• Advanced Diploma in Midwifery, NQF Level 7.

Or

• Advanced Diploma in a Nursing-related field, NQF Level 7.

Or

• Bachelor of Nursing, NQF Level 7, NQF Level 7.

Or

• Bachelor of Nursing Science, NQF Level 7.

And

• Registered/professional nurse and midwife with the South African Nursing Council (SANC).

And

• At least two years' experience as a registered nurse. This experience is inclusive of Community service.

This qualification consists of the following compulsory modules at NQF Level 8 totalling 140 Credits.

Compulsory Modules, Level 8, 140 Credits

• Ethos and professional practice, 8 Credits.
• Evidence-based practice, 12 Credits.
• Professional and career development, 4 Credits.
• Specialist Midwifery Care 1, 32 Credits.
• Specialist Midwifery Care 2, 40 Credits.
• Midwifery Practice Specialist, 44 Credits.

1. Practice and facilitate specialist midwifery care within the ethical and legal parameters of the profession.
2. Apply the knowledge of and facilitate evidence-based practice in the specialised midwifery field to solve contextual problems and develop policies and guidelines.
3. Appraise and develop self, peers and Midwife Specialist learners by facilitating self-directedness/leadership and lifelong learning to maintain competence.
4. Facilitate advocacy for the profession and provision of specialised midwifery professional support for personnel, patients or clients, families and communities.
5. Engage in planning, commissioning and managing specialised midwifery units.
6. Engage in scholarly activities to inform evidence-based practice in specialised midwifery units.
7. Utilise, manage and communicate data to support decision-making and research.
8. Render and coordinate patient-centred specialist nursing or midwifery practice within a continuum of care using the scientific approach, integrating biomedical and psychosocial sciences including advanced pharmacology.
9. Mobilise appropriate resources to implement standards of practice relevant to midwifery specialisation, to ensure quality patient care and safety.
10. Collaborate within the inter- and intra-professional team by engaging in health dialogue, shared leadership, decision making and sound clinical judgement.
11. Participate in the design, development, implementation and evaluation of midwifery policies, programmes and projects at provincial or national level.
12. Develop and implement institutional policies, protocols, and guidelines in midwifery, utilising the process of change management in the improvement of quality of care.

Associated Assessment Criteria

Associated Assessment Criteria for Exit Level Outcome 1

• Conform to the relevant code of ethics and behaviour in the practice of specialised midwifery care.
• Apply critical decision-making, and moral reasoning models and principles to make clinical judgements and resolve ethical dilemmas within the specialised midwifery practice.
• Account for own professional judgement, actions, and outcomes of specialised midwifery care and provide continued competence.
• Identify and apply the relevant current legislation, policies, regulations and guidelines pertaining to specialised midwifery practice.
• Document accurately, comprehensively and timeously all specialised midwifery care activities considering the legal requirements for record keeping.
• Discuss the Midwife Specialist's role in the management of misconduct and risks taking into consideration the institutional protocols, protocols and ethical-legal framework.

Associated Assessment Criteria for Exit Level Outcome 2

• Engage in specialised midwifery practice and the process of evidence-based practice.
• Apply the evidence-based specialised midwifery practice and appropriate methodology of gathering evidence for practice, education and management, for example, systematic or scoping reviews, and appraisal of articles, practice based-research and publication.
• Use of evidence-based specialised midwifery practice and critically analyse the various levels of evidence.

Associated Assessment Criteria for Exit Level Outcome 3

• Apply leadership skills appropriate to leadership styles, principles and theories of midwifery management.
• Effectively facilitate Continuous Professional Development (CPD) for self and others as well as for lifelong learning by creating a positive learning climate in the workplace through the processes of mentorship, preceptorship, supervision, and performance appraisal.
• Conduct the performance appraisal processes as part of the performance management and development system.
• Utilise the feedback gained from self-reflection, peers, learners, management and other relevant stakeholders to improve effectiveness in the Midwife Specialist role.
• Examine various risk factors that impact health and wellness within the workplace and apply strategies to care for self, peers, employees and learners.

Associated Assessment Criteria for Exit Level Outcome 4

• Discuss the purpose of the advocacy role for a Midwife Specialist.
• Apply advocacy principles to ensure safe and quality care in various midwifery care settings.
• Use appropriate communication skills and channels in facilitating advocacy.
• Lobby and/or participate in interest groups to influence legislation and policy affecting the role performance.

Associated Assessment Criteria for Exit Level Outcome 5

• Critically analyse the levels and or classification of the respective specialised midwifery units.
• Delegate tasks considering the burden of diseases and priority services as determined by current events.
• Participate in the evaluation of the existing Midwifery Specialist unit.
• Plan and delegate the roles and responsibilities of tasks within the inter and intra-professional team.

Associated Assessment Criteria for Exit Level Outcome 6

• Conduct the appropriate search engines and databases for review of the literature to inform midwifery evidence-based practice.
• Use appropriate methods to generate evidence for utilization in midwife specialist practice (e.g. research, systematic reviews etc.)
• Peer review journals and share evidence.
• Base activities on scientifically proven evidence in the midwifery specialist practice.
• Actively participate in inter and intra-professional dialogues, debates or discourses in quality improvement.

Associated Assessment Criteria for Exit Level Outcome 7

• Collect all data/information/ documents in the context of the midwife specialist practice, for utilisation and storage in accordance with the set standards.
• Utilise the comprehensive data, information and emerging evidence pertinent to the respective specialist practice.
• Identify problems and diagnose opportunities for improvement based on gathered and critically analysed assessment data from the patients/clients, families, communities, learners or employees including current scientific evidence.
• Respect intellectual property and avoid plagiarism in all documents.

Associated Assessment Criteria for Exit Level Outcome 8

• Discuss the position of specialised midwifery service within the health care system.
• Perform the full range of services within the specialised midwifery practice.
• Render specialised midwifery care that integrates promotive, preventive, curative, rehabilitative and palliative care in a healthcare continuum.
• Apply knowledge, skill and attitudes to render specialised midwifery care in accordance with national and international standards and protocols of the specialised midwifery practice.
• Formulate nursing or midwifery diagnoses congruent with the patient's/client's clinical manifestations/data based on accurate analysis and interpretation of data obtained from scientific, laboratory, diagnostic, technological and psycho-sociocultural assessment including consultation of relevant/current literature/evidence.
• Plan individualised midwifery interventions considering the patient's/client's needs, values, beliefs, preferences, culture and contextual variables, for example, disease burden, health risks, national priorities, etc.
• Plan midwifery interventions based on formulated nursing diagnoses, and application of specialised knowledge and skills (competencies) including advanced pharmacology in collaboration with the inter- and intra-professional team.
• Implement timeously, accurately, safely and effectively the planned midwifery interventions in accordance with set evidenced-based midwifery standards, guidelines, protocols and algorithms.
• Plan health care interventions in collaboration with the patient or client, family and relevant members of the health care team.
• Prepare nursing interventions to include patients/clients, families, and nurses in the lower-level care for continued care in the hospital and community in accordance with the health status and health literacy of the patient/client.
• Document and revise timeously and effectively midwifery interventions based on critical analysis of the monitoring and evaluation data and reaching a sound clinical judgement.

Associated Assessment Criteria for Exit Level Outcome 9

• Identify the infrastructure and equipment needed in the midwifery specialisation.
• Render care, operate and monitor the equipment used in the specialised midwifery.
• Employ sound asset management principles to ensure appropriate, adequate, well-maintained and up-to-date equipment.
• Assign staff to nurse care considering the specialist qualification and its competencies, experience, standard nurse-patient ratios for the specialised midwifery, job description and skill mix.

Associated Assessment Criteria for Exit Level Outcome 10

• Identify, share and collaboratively solve practice problems in the midwifery specialist area by informed decisions and sound clinical judgement.
• Appropriately and timeously consult in the provision of holistic care in a healthcare continuum through awareness of one's competence.
• Appropriately and timeously carry out patient referrals as dictated by the patient's condition and in accordance with the referral guidelines.
• Promote visible participation recognised by the members of the team in the inter-and intra-professional team.

Associated Assessment Criteria for Exit Level Outcome 11

• Participate in the development of policies, programmes and projects and apply the steps in the development of policies, programmes and projects.
• Critically analyse own role and responsibilities within the inter- and intra-professional policy/project team in project and policy development.
• Participate in advocacy for the nursing profession and patients/clients, families and communities in the specialist area.
• Participate in project development including appropriate communication (negotiation, bargaining, assertiveness, persuasion, etc.).
• Timely and adequately provide necessary feedback to relevant stakeholders.

Associated Assessment Criteria for Exit Level Outcome 12

• Evaluate the process and or steps of development of policies, standards, guidelines and protocols.
• Involve relevant and pre-determined stakeholders in the development of policies, standards, protocols and guidelines.
• Apply appropriate methods in the development and evaluation or testing of guidelines and protocols.
• Implement the new policies, protocols and guidelines to the midwifery specialisation and apply the change process.
• Collaboratively revise developed policies, protocols and guidelines at appropriate intervals and approve as per the institutional policy for the midwifery specialisation.