Continuing professional development and challenges facing newly graduated midwives in Papua New Guinea

Abstract

<p><strong>Background: </strong>The Maternal Mortality Ratio in Papua New Guinea (PNG) in 2008 was estimated at more than 700 deaths per 100,000 live births. In recognition of the high MMR, a Ministerial Taskforce was established in 2009 with recommendations to urgently address the workforce capacity in regard to maternal and child health services. In 2010, a new competency-based Bachelor of Midwifery curriculum was introduced into four universities in PNG and an increase in the numbers of midwifery students took place over a four year period.</p><p><strong>Aim: </strong>The aim of this study was to explore the experiences of Papua New Guinean midwifery graduates from the 2012 and 2013 Bachelor of Midwifery cohorts. These graduates were among the first to complete the revised national midwifery curriculum designed to improve the knowledge and skills of a registered midwife graduate.</p><p><strong>Method: </strong>A descriptive exploratory study was undertaken to explore the experiences of 174 graduates in the first two years post-graduation. All graduates that were able to be contacted were provided with information about the study, consented and were interviewed either face-to-face or by phone/email. Quantitative data were analysed using simple descriptive statistics in SPSS and qualitative data underwent content analysis and coding by the research team.</p><p><strong>Findings: </strong>Almost all (90%) graduates were working as midwives with 39% of graduates working in rural and remote locations across PNG. Midwifery education prepared graduates well for their work as midwives, but many commented that the course needed to be longer to improve feelings of competence. Professional support during their graduate year varied depending on location and motivation of supervisors. Many graduates, particularly those in rural areas, expressed the desire to work under clinical supervision in a hospital setting for a period of 6-12 months at the end of their training to become more skilled and confident prior to seeking employment.</p><p><strong>Conclusion: </strong>Most midwifery graduates from the new curriculum found employment as midwives. Only a minority of graduates have had opportunities for continued professional development or support from a mentor of senior colleague. Regular, ongoing professional development and supervision needs to be initiated for the provision of skilled and evidence based care. Support and incentives for staff to work in rural and remote areas should be considered.</p>