Experiences of a new cadre of midwives in Bangladesh: findings from a mixed method study

Abstract

Background Bangladesh did not have dedicated professional midwives in public sector health facilities until recently, when the country started a nation-wide programme to educate and deploy diploma midwives. The objective of the findings presented in this paper, which is part of a larger study, was to better understand the experience of the midwives of their education programme and first posting as a qualified midwife and to assess their midwifery knowledge and skills. Methods We applied a mixed method approach, which included interviewing 329 midwives and conducting 6 focus group discussions with 43 midwives and midwifery students. Sampling weights were used to generate representative statistics for the entire cohort of the midwives deployed in the public sector health facilities. Results Most of the midwives were satisfied with different dimensions of their education programme, with the exception of the level of exposure they had to the rural communities during their programme. Out of 329 midwives, 50% received tuition fee waivers, while 46% received funding for educational materials and 40% received free accommodation. The satisfaction with the various aspects of the current posting was high and nearly all midwives reported that a desire to work in the public sector in the long run. However, a significant proportion of the midwives expressed concerns with equipment, accommodation, transport and prospect of transfers. The scores on the knowledge test and self-reported skill levels were varied but reasonably high. Conclusion While the midwives are highly motivated, satisfied with many aspects of their current jobs and have adequate knowledge and skills, there are some bottlenecks and concerns that, if unaddressed, may derail the success of this programme. To capture the career progress of these midwives, additional research, including a follow-up study with the same cohort of midwives, would be beneficial to this programme.

Enhancing quality midwifery care in humanitarian and fragile settings: a systematic review of interventions, support systems and enabling environments

“…21 Three countries are categorised as having highest fragility, two as very high fragility, two as high fragility and three as fragile settings. These countries included Afghanistan, [37][38][39][40][41][42][43] Bangladesh, [44][45][46][47][48] Nigeria, [49][50][51][52] Democratic Republic of Congo (DRC), 53 54 South Sudan and Sudan, 55 56 Ethiopia, Pakistan, Uganda and Liberia. Afghanistan (n=7), Bangladesh (n=5), Nigeria (n=4), DRC (n=2) made up most of the studies (table 2).…”

“…42 44 In Bangladesh, almost 40% of the tasks a midwife performed were unrelated to their scope of practice. 44 Two studies discussed the issue of mixed roles and task shifting for midwives as a workforce solution. 42 44 In some HFS, such as the DRC and Afghanistan, midwives are the only providers in health facilities.…”

Optimizing the contributions of nursing and midwifery workforces: #Protect, #Invest, #Together

“…The first main area of action identified in SOWN was investment in the “massive acceleration” of nursing education to address global needs, meet domestic demand, and respond to changing technologies and advancing models of integrated health and social care. Papers that have been published under the Call include a focus on policy opportunities in increasing the profile and impact of nursing in Saudi Arabia, with a strong focus on education [ 3 ]; a study reporting on the need for alignment and contribution of nursing doctoral programmes to achieve the sustainable development goals in Brazil [ 4 ]; an analysis of the experiences of a new cadre of midwives in Bangladesh [ 5 ], a scoping review of effective mentoring of working nurses [ 6 ], and an assessment of the impact of a mLearning application on nurses’ and midwives’ knowledge and skills in Rwanda [ 7 ].…”

An Uninformed Decision-Making Process for Cesarean Section: A Qualitative Exploratory Study among the Slum Residents of Dhaka City, Bangladesh

“…Some of those NGOs provide maternal and child health care, along with other services [49]. In addition to the NGO services, over the last 10 years, the government of Bangladesh has taken the initiative to increase the number of midwives to improve the perinatal care services in Bangladesh [50,51]. An evaluation of a midwife-delivered community-based maternity care program in Bangladesh revealed lower maternal mortality in the areas where the midwives were available [52].…”