Exploring the Understanding and Triage Practices of Midwives Working in District Hospitals of Mpumalanga Province, South Africa

Triage in healthcare involves the process of prioritizing patients in their level of urgency and also the allocation of resources. However, triage has been used mainly in emergency departments around the world. Only in recent years have triage systems been gradually implemented in maternity units. It is a relatively new concept in maternity units and its landscape is not properly understood.

The study aimed to explore the understanding and practices of triage by midwives working in the labour wards of selected district hospitals in Mpumalanga province, South Africa.

A qualitative, exploratory, and descriptive research design was used to explore the practices and understanding of midwives regarding labour ward triage. A purposive sampling method was used to select experienced midwives who work in labour wards. The sample size was directed by data saturation, reached at the 20^th participant. The data were then analysed using thematic analysis. Trustworthiness was ensured through the Lincoln and Guba criteria (1985).

Two themes emerged regarding midwives' understanding and practices of triage namely, a nuanced understanding of triage in the labour wards and a description of existing triage practices of midwives. The themes were interpreted into five sub-themes.

The study revealed that the absence of triage systems in maternity units delays obstetric care, contributing to poor maternal and perinatal outcomes and rising litigation in South Africa. The findings call for the National Department of Health to strengthen triage policies and guidelines and suggest co-designing a triage system with midwives to enhance implementation and feasibility.