Papers by Thivhulawi Malwela
Systematic Reviews, 2024
Background Deoxyribonucleic acid (DNA) methylation is one of the epigenetic modifications that ha... more Background Deoxyribonucleic acid (DNA) methylation is one of the epigenetic modifications that has gained a lot of interest as a factor influencing fetal programming and as a biomarker for adverse pregnancy and birth outcomes (APBOs). Epidemiological studies have demonstrated that DNA methylation can result in adverse pregnancy and birth outcomes (APBOs) including miscarriage, intrauterine growth restriction (IUGR), low birth weight (LBW), sepsis, and preterm birth (PTB), which may later result in diseases in adulthood. However, the mechanism by which DNA methylation influences these APBOs remains unclear. The systematic review will assess the association between global and gene-specific DNA methylation with adverse pregnancy outcomes. Method The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 checklist will be followed when conducting this systematic review. To develop the search strategy the PI(E)COS (population, intervention/exposure, comparator/control, outcome, and study designs) framework will be followed. Thus far, the research team has retrieved 4721 from Cochrane Library, PubMed, Web of Sciences, and MEDLINE. Out of these, 584 studies have been screened for eligibility, and approximately 124 studies meet the inclusion criteria. Pending the search results identified from the grey literature. For identification of unpublished studies in journals indexed in electronic databases, Google Scholar will be used. I.M and A.S will separately extract data from the articles and screen them, if there are any disagreements between I.M and A.S, then the L.M will resolve them. The methodological quality and bias risk of the included studies will be evaluated using the Critical Appraisal Skill Programme CASP) checklist. I 2 and χ2 alpha = 0.10 statistic will be used for assessing statistical heterogeneity between studies. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach will be used to assess and grade the overall quality of extracted data. Ethics and dissemination Ethical approval is not required. The systematic review will assess available literature on possible associations between DNA methylation with adverse pregnancy and birth outcomes (APBOs) including LBW, IUGR, miscarriage, sepsis, and PTB. The findings could help guide future research assessing DNA methylation and other APBOs. Systematic review registration PROSPERO CRCRD42022370647.
DOAJ (DOAJ: Directory of Open Access Journals), Aug 1, 2022
PubMed, Jan 10, 2024
Background: Early Antenatal Care (ANC) initiation is aimed at improving maternal and perinatal he... more Background: Early Antenatal Care (ANC) initiation is aimed at improving maternal and perinatal health outcomes through the identification of complications and determining the level of care needed. This study aimed to determine the voices of midwives on the provision of early initiation of ANC following positive gravindex. Materials and methods: The phenomenology approach underpinned the study. The participants included midwives providing ANC at health facilities under Tshino-Mutsha local area in May-December 2020. Nonprobability, purposive sampling was used to select four clinics and to sample 20 midwives. Semistructured face-to-face, in-depth interviews were conducted using an interview guide. Data saturation was reached at Participant 15; however, the researcher continued until Participant 20. Trustworthiness was ensured and ethical principles were adhered to. Data analysis was done using Tesch's open coding approach. Results: Two themes and seven subthemes emerged, as challenges related to the provision of midwifery practice and to pregnant women. The seven subthemes were the shortage of resources, poor support of midwives, poor adherence to the available protocol for the provision of ANC, blaming of midwives by management and community, late ANC booking by pregnant women, denial of pregnancy by young women ignorance leading to a general resistance to ANC instructions, hence late booking. Conclusions: It was concluded that shortage of human and material resources hindered the initiation of early ANC to detect, prevent, and manage the existing and potential causes of maternal and newborn mortality and morbidity.
Nursing reports, Oct 6, 2023
Research Square (Research Square), Oct 2, 2023
PubMed, Jul 1, 2022
Pre-rupture of membranes prior labour initiation could complicate approximately 5% of pregnancies... more Pre-rupture of membranes prior labour initiation could complicate approximately 5% of pregnancies and could be associated with a high incidence of perinatal morbidity and mortality complications. The major complications could be chorioamnionitis and cord compression resulting in hypoxia. This study aimed to assess the health literacy of mothers on perinatal outcomes following pre-rupture of membranes at Thulamela B clinics of Vhembe district. A quantitative research approach with a cross-sectional descriptive design was used. The study population comprised a total of 210 lactating mothers within 6 weeks following delivery, irrespective of the mode of delivery were purposively selected. Data were collected by the researchers through self-administered questionnaires. The Statistical Package for Social Sciences (SPSS) version 25 was used for data analysis. The results are presented in the form of tables and graphs based on probability allowing judgment to be made on variables. Validity and reliability were ensured. Ethical clearance was obtained from the University of Venda Research Ethics Committee and permission to access health facilities from the Limpopo Province Department of Health. Findings revealed that limited and inadequate health literacy towards pre-rupture of membranes contributes to perinatal morbidity and mortality, with associated factors like poor antenatal care attendance, delayed health seeking, defaulting, and loss of follow-up. Recommendations to emphasise the provision of preconception and antenatal care where health information on risks and danger signs of PROM to perinatal outcomes are given were made.
Nursing & Primary Care, 2017
Nursing and Midwifery education takes place under nursing school (theory) and clinical placement ... more Nursing and Midwifery education takes place under nursing school (theory) and clinical placement (practice). Effective learning need classrooms, equipped libraries facilities, whilst conducive clinical areas with enough medical supplies, equipment and other material facilitate application of theory to practice. The aim of the study was to determine factors affecting integration of midwifery nursing science theory with clinical practice in Vhembe district, Limpopo province. A qualitative explorative, descriptive and contextual design was used. Purposive sampling method was used to select 4 lecturers from Nursing College, and 18 level IV (Finalists) student midwives from training hospitals, in Vhembe district. Data from students were collected through three focus group interviews, whilst in-depth face to face interview was used to collect data from lecturers. Interviews were conducted until data saturation was reached and data were analysed through open coding method. Findings revealed that systems and organizational factors hindered the students to integrate theory with clinical practice when allocated for clinical learning experience. This included shortage of accommodation next to the training hospitals, shortage of medical supply, equipment's and other materials. Student's selection systems, shortage of classrooms, library facilities and dilapidated physical structures as well as short period of learning and clinical exposure. Recommendations were made on budget to erect or provide suitable accommodation within the college and next to clinical areas to accommodate students during their training, improve in their selection criteria, college's physical infrastructure needs to be upgraded and to add more classes that will accommodate more students and the management need to advocate for accreditation of more training hospitals.
Curationis
Background: Preterm birth is often unexpected and life-threatening for the baby and/or the mother... more Background: Preterm birth is often unexpected and life-threatening for the baby and/or the mother. When admitted to the hospital, midwives need to provide informational, instrumental, psycho-cultural and emotional support to enhance post-discharge care.Objectives: This study aimed to explore and describe the support provided to parents of preterm infants in preparing for post-discharge care. The study was conducted in three district hospitals in the Mopani district, South Africa.Method: A qualitative approach wherein explorative, descriptive and contextual designs were used. A non-probability, convenience sampling was used to select 23 midwives who were working in the maternity unit for at least 2 years. Data were collected through in-depth individual semi-structured interviews until data saturation was reached. The data were analysed through Tesch’s open coding method. Trustworthiness was ensured through credibility, transferability and confirmability. Ethical principles adhered to...
Journal of Respiration
Background: Effective communication between health care professionals, admitted patients, and the... more Background: Effective communication between health care professionals, admitted patients, and their families is crucial to improving the health care outcomes and patient satisfaction. Hence, barriers to effective communication cause a lot of confusion, frustration, and misunderstanding. The study aimed to identify the perceived barriers to effective communication between patients, their families, and health care professionals during the COVID-19 pandemic in public hospitals in Limpopo Province. The study was conducted in rural areas of Vhembe District, Limpopo Province. Methodology: A qualitative exploratory descriptive method was adopted to explore and describe the barriers of effective communication among patients, relatives, and health care professionals during the COVID-19 pandemic in public hospitals in the Vhembe District. Eleven (11) participants were purposively selected. Unstructured in-depth individual interviews were used to collect data and analyzed using thematic analys...
Gynecology & Obstetrics, Feb 6, 2015
Patient Preference and Adherence
Background: Early postnatal discharge is perceived as a factor that contributes to possible mater... more Background: Early postnatal discharge is perceived as a factor that contributes to possible maternal, neonatal complications and deaths during the first week of delivery. Continuing with provision of home-based postnatal care by the primary caregivers is crucial to prevent morbidity and mortality. Purpose: The purpose was to explore the experiences of primary caregivers of continuing with the provision of early postnatal care at home. Method: A qualitative research approach, which was explorative, descriptive, and contextual was conducted in the three selected districts of different ethnic groups at Limpopo Province in October 2019. A non-probability, purposive sampling was used to conveniently sample 20 primary caregivers of postnatal women. Data were collected during the first 2 weeks of delivery through indepth individual semi-structured interviews until data saturation was reached. Data were analysed through a thematic analysis framework applying Tesch's open coding method. The study was done in Limpopo district, South Africa. Findings: The findings revealed a theme, namely, knowledge and skills of providing community-based postnatal care and three subthemes; early postnatal care to detect and prevent possible complications to the mother; general postnatal care, and early neonatal care to detect and prevent possible complications. Conclusion: Primary caregivers displayed acceptable indigenous skills and knowledge of providing early postnatal care. However, the skills of detecting potential danger signs were not adequately displayed. It was recommended that midwives need to create awareness to primary caregivers from the antenatal through postnatal care period. Community Health Workers to assist during immediate postnatal checkups (mother and neonate) which is done within 72hours of delivery. The health education, counseling, and community-based awareness campaigns are to be done with a focus on the detection and prevention of possible complications to mother and baby.
African Journal of Midwifery and Women's Health
Background/Aims Most African states are faced with challenges in the healthcare sector, such as t... more Background/Aims Most African states are faced with challenges in the healthcare sector, such as the lack of skilled healthcare professionals, materials and supplies and inadequate infrastructure. These challenges lead to an increased rate of preterm births. The aim of this study was to explore and describe barriers to the prevention of preterm births in the obstetric units of Limpopo Province. Methods An explorative, descriptive design was used to obtain primary data, which were used to develop guidelines to assist resource-limited obstetric units. Purposive sampling was used to select 10 managers and 15 midwives, making a total of 25 participants. In-depth individual interviews were used to collect data that were analysed using Tesch's open coding approach. Results The barriers to the prevention of preterm births in Limpopo Province, South Africa were a shortage of healthcare professionals, a lack of emotional and psychological support and poor communication. Conclusions The su...
Nursing: Research and Reviews
Annals of Global Health, Feb 3, 2020
Background:Inadequate neonatal facilities in rural areas is one of the challenges affecting the m... more Background:Inadequate neonatal facilities in rural areas is one of the challenges affecting the management of preterm infants. In low income countries with limited resources, over 90% of preterm babies die within few days of life.Purpose:The purpose of this study was to describe the challenges encountered by midwives when providing care to preterm infants at resource limited health facilities in Limpopo Province, South Africa.Methods:Qualitative research approach, using exploratory and descriptive design was used. Non-probability purposive sampling was used to select twenty three midwives who had an experience of two or more years in maternity. Data was collected using unstructured individual interviews, which were voice recorded and transcribed and data analysed qualitatively through the open-coding method.Findings:Revealed one theme, preterm condition and expected care; with sub-themes namely; perceived causes of preterm complications and deaths, preterm babies experience several difficulties which need specialised care, the need for constant individualised care and monitoring of preterm infants by midwives, functional relevant equipment needed for care of preterm infants, a need for constant training for midwives regarding care of preterm infants, and importance for a proper structure to house preterm infants which will lead to quality care provision.Conclusion:Preterm babies need simple essential care such as warmth, feeding support, safe oxygen use and prevention of infection. Lack of adequate resources and limited skills from midwives could contribute to morbidity and mortality. Health facility managers need to create opportunities for basic and advanced preterm care to equip the skills of midwives by sending them to special trainings such as Limpopo Initiative Neonatal Care (LINC), Helping Baby Breath (HHB) and Neonatal Intensive Care Unit (NICU). Operational managers should be involved in the identification, procurement and supply of required equipment. Continuous health education should be provided on the mothers about kangaroo mother care (KMC) and measures to prevent infections in the neonatal unit.
African Journal of Primary Health Care & Family Medicine, 2016
Background: Professional midwives have an important role to play in midwifery training to produce... more Background: Professional midwives have an important role to play in midwifery training to produce a competent midwife. According to the social learning theory, professional midwives act as role models for students. When allocated for clinical learning experiences in the training hospitals, students will have the opportunity to observe the well-trained, skilled, and experienced professional midwives. The whole process will enable students to integrate theory with practice and they will become competent.Aim: The aim of this study was to determine the factors affecting integration of midwifery nursing science theory with clinical practice as perceived by midwives.Setting: The study was conducted at the training hospitals in Vhembe district of the Limpopo Province, South Africa. These hospitals were: Donald Fraser, Siloam, and Tshidzini.Methods: A qualitative explorative, descriptive and contextual design was used. A Nonprobability, convenient sampling method was used to select 11 midwi...
Uploads
Papers by Thivhulawi Malwela