Distribution of midwives in Mongolia: A secondary data analysis

Erdenee, Oyunchimeg; Tumejargal, Amartuvshin; Parchaa, Tsetsegmaa; Yamazaki, Chiho; Koyama, Hiroshi

doi:10.1016/j.midw.2020.102704

Cited by 3 publications

(4 citation statements)

References 20 publications

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“…This observation is in line with the 2021 UHC Monitoring Report which found that the within-country relationship between inequalities in accessing essential health services and both the education and urbanization levels was particularly pronounced in low-income countries [ 55 ]. It also supports studies which, using subnational data, identified inequalities in the distribution of health workers, correlation with health spending, and impacts on PHC service delivery and health outcomes [ 56 – 58 ]. Related frameworks have also suggested that inequities in various domain are intrinsically correlated and that inequities tend to cluster in particular in the poorest countries as having similar root causes [ 42 ].…”

Section: Discussionsupporting

confidence: 78%

Inequal distribution of nursing personnel: a subnational analysis of the distribution of nurses across 58 countries

et al. 2022

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Background Nursing personnel are critical for enabling access to health service in primary health care. However, the State of the World’s Nursing 2020 report showed important inequalities in nurse availability between countries. Methods The purpose of this study/analysis was to describe the differences in nurse-to-population density in 58 countries from six regional areas and the relationship between differences in access to nurses and other indicators of health equity. Results All countries and income groups showed subnational inequalities in the distribution of nursing personnel with Gini coefficients ranging from 1 to 39. The latter indicated situation such as 13% of the population having access to 45% of nurses in a country. The average max-to-min ratio was on average of 11-fold. In our sample, the African region had the highest level of subnational inequalities with the average Gini coefficient of 19.6. The European Region had the lowest level of within-country inequalities with the average Gini coefficient being 5.6. A multivariate analysis showed a clustering of countries in three groups: (1) high Gini coefficients comprised mainly African countries; (2) moderate Gini coefficients comprised mainly South-East Asian, Central and South American countries; (3) low Gini coefficients comprised mainly Western countries, Japan, and Korea. The analysis also showed that inequality in distribution of nurses was correlated with other indices of health and inequality such as the Human Development Index, maternal mortality, and life expectancy. Conclusions This study showed that there is a high level of geographic inequality in the distribution of nurses at subnational level. Inequalities in nursing distribution are multifactorial, to improve access to nurses, policies should be bundled, tailored to the local context and tackle the various root causes for inequalities.

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Section: Discussionsupporting

confidence: 78%

Inequal distribution of nursing personnel: a subnational analysis of the distribution of nurses across 58 countries

et al. 2022

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“…The most important issue for strengthening midwifery is the need for continuing in-service training and postgraduate education. The potential for short courses to provide significant learning outcomes is questioned; however, it is acknowledged that several factors may influence the programs of training, including unsubstantiated quality of training, lack of midwifery workforce and well-prepared educators, and the widespread geographical locations of nurse-midwives across the country 34 . To address these challenges, we propose actionable and achievable recommendations as given Table 1 .…”

Section: Commentarymentioning

confidence: 99%

“…• The role of the midwife (as defined by the ICM) does apply to midwives employed in tertiary services • Midwifery will be recognized as an independent and science-based profession, no longer considered an assistant role to the obstetricians • Management position will exit each level of service • Establishing a clinical career path that encompasses the advanced practitioner's roles • Existing salary structure will be changed • Organizational culture would be that the midwife-led model dominates • Midwives' engagement in decision-making, supervisory roles, and responsibilities for maternal and newborn care in practice will be enhanced • Midwife's roles will be well-defined The potential for short courses to provide significant learning outcomes is questioned; however, it is acknowledged that several factors may influence the programs of training, including unsubstantiated quality of training, lack of midwifery workforce and well-prepared educators, and the widespread geographical locations of nurse-midwives across the country 34 . To address these challenges, we propose actionable and achievable recommendations as given Table 1.…”

Section: Develop New Roles For Midwivesmentioning

confidence: 99%

Midwifery practice in Mongolia: Policy implications for accelerating care delivery transformation

Dovdon,

McCarley,

Kim

2024

Eur J Midwifery

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Midwives can play a significant role in reducing maternal and neonatal mortality rates as well as in improving maternal and perinatal health outcomes in low-and middleincome countries such as Mongolia. However, the shortage of midwives in Mongolia is severe. Despite the evidence indicating numerous challenges associated with substandard midwifery education and practice in Mongolia, there is a need for policy recommendations to accelerate the improvement of midwifery care delivery in the country. Therefore, we identified three main topics as key issues in Mongolian midwifery care: 1) the current training and service delivery in midwifery; 2) the potential for the development of the midwifery role; and 3) content requirements for the postgraduate certificate in midwifery. The World Health Organization report made forty recommendations to enhance the midwife's role to professional status. However, the absence of senior nursing/midwifery leadership in the Ministry of Health in Mongolia has hindered the implementation of the recommendations. To strengthen midwifery at a national level, it is imperative to make multilevel investments in supporting educators and clinical practitioners to ensure the delivery of high-quality midwifery care. This article represents an initial in-depth exploration of issues in Mongolian midwifery practice, with the aim of providing suggestions for practical avenues for enhancing midwifery care in Mongolia.

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“…The burden of maternal and infant morbidity and mortality (MMR), particularly in low- and middle-income countries (LMICs) has been a global concern [ 1 ]. This burden is mostly observed in resource limited regions, i.e., rural areas of LMICs [ 2 ]. For example, in Mongolia, the average annual MMR in remote aimags (provinces), depending on their geographic locations, is between 4 to 6 times higher than the capital city, Ulaanbaatar [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of outcome-based education on clinical performance and perception of pediatric care of the third-year nursing students in Mongolia

Lkhagvaa,

Tsogbadrakh,

Gochoosuren

et al. 2024

PLoS ONE

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Background Mongolian government has set improvement of clinical proficiency of nursing students as one of its priorities. Nursing professionals have the sentinel role in providing healthcare services in rural areas. Outcome-based education (OBE) offers a promising pedagogical approach to actively mentally engage students to strengthen their clinical proficiencies. We implemented a pilot project with the objective of comparing students’ clinical performance under OBE with our traditional didactic techniques. Methods The researchers implemented a non-equivalent two-armed quasi-experimental post-test-only’ design approach study. The intervention arm (n = 34) received OBE pediatric training, while the control arm (n = 32) received the traditional pedagogical pediatric nursing training. Each arm of the study completed 16 hours of theory, 32 hours of clinical skills practice and 32 hours of seminars in pediatric nursing care. Data were collected using a five-section instrument, Demographic, Competency Inventory, Nursing Students’ Satisfaction, Course Experience, and Objective Structured Clinical Examination. Performance and knowledge proficiencies were evaluated by applying the two-sided independent T-test. The distributions of categorical variables were assessed by Fisher’s exact test or chi-squared test of significance. Results The intervention arm had higher mean score value in the competency inventory (X¯ = 238.70, SD = ± 23.07) compared to the control arm (X¯ = 222.11, SD = ± 39.94) (P = 0.04); similarly, the mean value for nursing students’ satisfaction was higher for the intervention arm (X¯ = 117.87, SD = ± 15.94) compared to the control group (X¯ = 109.76, SD = ± 16.94) (P = 0.049). Additionally, the difference in the mean value for course experience questionnaire between the intervention arm (X¯ = 125.33, SD = ± 19.30) and the control arm (X¯ = 110.41, SD = ± 11.28) was statistically significant (P = 0.0001). Finally, the intervention arm had a higher mean value (X¯ = 85.40, SD = ± 6.11) for objective structural clinical examination compared to the control arm (X¯ = 81.56, SD = ± 7.01) (P = 0.023). Conclusion OBE pedagogical approach offers promising benefits to improving nursing students’ clinical competencies; additionally, the OBE approach seems to increase students’ satisfactions with their clinical curriculum.

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Distribution of midwives in Mongolia: A secondary data analysis

Cited by 3 publications

References 20 publications

Inequal distribution of nursing personnel: a subnational analysis of the distribution of nurses across 58 countries

Inequal distribution of nursing personnel: a subnational analysis of the distribution of nurses across 58 countries

Midwifery practice in Mongolia: Policy implications for accelerating care delivery transformation

The effect of outcome-based education on clinical performance and perception of pediatric care of the third-year nursing students in Mongolia

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