Midwifery manager’s experiences of knowledge and skills utilization by midwife specialists in the public health sector of South Africa

Introduction: Midwife specialists are trained professionals who render low and high-risk maternity and neonatal healthcare services across the globe. A workforce shortage of trained obstetricians and neonatologists in the rural parts of South Africa led to the rise of complicated births and neonatal conditions. Consequently, South Africa trained the registered midwives as midwife specialists to address the health needs of both mothers and neonates with life-threatening complications. While the country tried to train midwives, the existing literature proves that midwives are constrained to practice in the public health sector. This study is derived from a doctoral study in which midwife specialists’ knowledge and skills utilization were explored and described through the lens of multivariate populations. This part of the study aims to explore and describe the experiences of midwifery managers in midwife specialists’ utilization of knowledge and skills in the public health sector of South Africa. Methods: A qualitative, descriptive, explorative research design was followed. Twelve purposefully sampled midwifery managers participated in three focus group interviews. Data were analyzed using Collaizi’s descriptive method based on the emerging themes and categories. Results: Midwifery managers recognize midwife specialists as knowledgeable and skilled professionals who lack professional autonomy to utilize their knowledge and skills. Consequently, the midwife specialists were inconsistent in their practice and demonstrated over-reliance on physicians and midwifery managers. The inconsistent practice led to potential knowledge and skills loss. Midwifery managers associated these with the lack of specific practice regulations to guide midwife specialist’s practice regarding roles and responsibilities. Discussion: The study highlights midwife specialists in public health sectors cannot utilize their knowledge and skills optimally and cannot assume their specialist role in South Africa. The need to specify the roles and responsibilities of midwife specialists remains a challenge and call for revision of the practice regulations.