|dc.description.abstract||An emergency reaction is required in Africa because HIVIAIDS is a reality which may be
regarded as a developing crisis and a catastrophe. Approximately a third of all women in the
North-West Province are HIV positive. Because of their vulnerability against HIVIAIDS there
arose a need for health service provision to the HIV positive woman to focus specifically on
the reduction of the transmission of HIVIAIDS from mother to child. Mother to child
transmission is the biggest cause of HIV infection among children. Almost all HIV positive
children are infected during pregnancy, labour, childbirth or breastfeeding. Without the
necessary preventative measures as many as 25-35% of the children of HIV positive
mothers may be infected. The biggest percentage of infections, however, takes place during
labour and the birth process. In first world countries the mother has access to choices and
facilities to make an informed decision about antiretroviral therapy, as well as the method of
birth. In the North-West Province not all these options and facilities are available, and
therefore the knowledge and skills of midwives must be deployed to reduce vertical
transmission of HIV during the intrapartum practice. It is important that midwives have the
necessary knowledge about intrapartum practices and vertical transmission of HIV, in order
to distinguish between risky and safe intrapartum practices.
The purpose of this research was to determine whether midwives in the Southern region of
the North-West Province have sufficient knowledge of intrapartum practices to reduce
vertical transmission of HIV, as well as to determine the intrapartum practices in the
Southern region of the North-West Province. The ultimate goals, then, were to determine
how the national policy should be adapted and implemented in the Southern region of the
North-West Province to reduce HIV transmission during intrapartum practices.
A quantitive survey design was used. For the data collection a questionnaire and a control
list were used. The questionnaire and the control list, which are adapted and based on
literature, were submitted to research and subject specialists, after which they were adapted.
Permission was obtained for this research from the Department of Health in the North-West
Province, the ethics committee of the PU for CHE as well as each provincial hospital in the
Southern region in the North-West Province to conduct the research. A purposeful
availability sample of midwives working in the Southern region of the North-West Province
was used and a random sample was used for auditing the obstetric records. A total of 31
midwives participated as respondents, and 401 obstetrical records were audited. Data
analysis was performed by means of a frequency analysis, effect sizes and cross reference.
Based on these findings it was concluded that the midwives do have basic knowledge
regarding vertical transmission of HIV, but that this knowledge is not reflected in the
intrapartum practice. There is uncertainty about certain aspects where the latest research
about intrapartum practices are not implemented in practice.
Recommendations were accordingly formulated for nursing education, research and practice.
This research particularly focused on improving midwives' knowledge about intrapartum
practices to reduce the vertical transmission of HIV, so that this knowledge may result in
improved intrapartum practice. Recommendations are also made as to how the national
policy may be adapted and implemented in the Southern region of the North-West Province.||