The factors influencing the implementation of the post-natal home visit program by nurses in an urban health district, Botswana.

Abstract

The post natal home visit care program is a maternal and newborn home visit care program, designed to address the needs of the childbearing families following delivery and early discharge, irrespective of the place of delivery. The study was undertaken to determine the factors influencing the implementation of the post natal home visit care program by nurses and to make suggestions to resolve the problem in an urban health district in Botswana. A descriptive exploratory study, using both quantitative and qualitative methods guided the process. Two methods were used to collect data, namely, the developed checklist and four focus group discussions. Twelve clinics were sampled and checklists were completed for the twelve clinics by the researcher. A total of twenty eight Registered Nurses and Registered/Enrolled Nurse Midwives were recruited from the participating twelve clinics through purposive sampling. This included nursing managers and senior nursing staff. The findings reflect the post natal home visit care program deficits. Protocols and logistics such as transport and staff for the program were not in place. Furthermore, the results also reflect various factors such as lack of motivation, lack of support from management and co-workers, distance and fear of stigmatisation as reasons for not implementing the post natal home visit care program. The participants felt that there was need to implement the program and attached merit to its importance. Finally, the participants made suggestions to overcome the deficit such as team work, commitment to work, academic development and improvement of management and supervision. In conclusion, failure to implement the program represents a health delivery deficit. There is need for improved management and supervision to balance the needs of Registered/Enrolled Nurse Midwives and the needs of the organization in order to attain better results. There is also a need for the provision of logistics needed for the post natal home visit care program such as transport and manpower. Finally, there is need for the coordination of the post natal home visit program by the District Health Team to aid implementation so as to provide the essential service.