Strengthening regulation of traditional midwifery practice in Lesotho

Abstract

The aim of this study was to formulate strategies that might strengthen the regulation of traditional midwifery practice in Lesotho. Such systems could promote safe traditional midwifery practice. Semi-structured interviews were conducted to identify and describe the perceptions of traditional midwives, registered nurses and members of the Lesotho Universal Medicine Men and Herbalist Council (LUMMHC), regarding the regulation of traditional midwifery practice in Lesotho. The rationale underlying the study was to suggest strategies to strengthen the regulation of traditional midwives to promote their accountability for client care offered in the hard-to-reach areas where professional health care is limited. Semi-structured individual interviews were conducted (until data saturation had been reached) with 12 traditional midwives, nine registered nurses and five members comprising the Lesotho Universal Medicine Men and Herbalist Council. Content analysis of the data was done independently by two coders who reached consensus about the identified themes and categories. The research objectives were to identify: • and describe the perceptions of traditional midwives, members of the Lesotho Universal Medicine men and Herbalist Council, and registered nurses regarding the regulation of traditional midwifery practice • strategies that could be used to regulate traditional midwifery practice in Lesotho. The first theme was described as the perceptions of traditional midwifery practice, including the categories: positive and negative perceptions of all the role players who took part in the study. The second theme addressed the perceptions of roles of other role players to improve the practice of traditional midwives, including the following categories: role of registered nurses, role of the Lesotho Universal Medicine Men and Herbalist Council and the role of other role players including traditional leaders and chiefs. The third theme addressed the perceived needs to improve the practice of traditional midwives, including categories: knowledge needs, physical needs, collaboration needs at local level and the need for regulation. The fourth theme described the perceptions of role players regarding the regulation of traditional midwifery practice, according to the combined perceptions of the three stakeholder groups. The fifth theme described suggestions related to strategies regarding the regulation of traditional midwifery practice, including collaboration at government level, legislation, registration, licensing and certification; reporting, investigating instances of malpractice and holding disciplinary hearings. Each theme was discussed and compared with relevant data obtained from the literature. Conclusion statements of each theme were provided, and they served as a basis for the formulation of strategies that would assist in strengthening the regulation of traditional midwifery practice in Lesotho. The research report finished with the conclusions, limitations and recommendations of the study for the Ministry of Health, the LUMMHC, for traditional midwifery practice and for further research.