Abstract
BackgroundIn order to promote sustainable midwifery education, it is important to understand what the structural shortcomings are. In this study of 38 public nursing institutions in Bangladesh, we aim to identify a number of structural shortcomings and to discuss strategies for limiting them. MethodsAn evaluated context-specific accreditation assessment tool consisting of 37 multi-choice closed-response questions encompassing 14 educational standards aligned with international standards for midwifery education programs and competences for midwifery educators was used to assess all public nursing institutions in Bangladesh (n=38), the results of which are presented in simple descriptive statistics; number (n), percentage (%), mean, SD and minimum-maximum value. ResultsProvision around clinical practice sites is the key structural shortcoming within the Bangladeshi midwifery educational system. Twenty-five percent of the institutions provided no opportunity for midwifery students to practice comprehensive sexual and reproductive health care. Twenty-nine per cent of the clinical sites were not aware of the content of midwifery courses and syllabi. Finally, one third of students achieving a midwifery qualification did not meet the learning outcomes to support women in birth. ConclusionsTo measure progress towards national and global milestones to ensure students are equipped with required competencies before graduating as registered midwives will be difficult to meet unless shortcomings within the educational system are addressed. We recommend (i) the inclusion of clinical placement sites in future assessments, (ii) the introduction of an integrated feedback-appeal-response system, and (iii) the development of a system for improved communication links between educational institutions and clinical placement sites.
Highlights
In order to promote sustainable midwifery education, it is important to understand what the structural shortcomings are
Bangladesh, with a current maternal mortality ratio of 173 per 100,000 live births and a neonatal mortality ratio of 17.1 per 1000 live births [5], has in recent decades rapidly scaled up its midwifery education system [4,6], increased its midwifery educator capability [7,8,9], improved students’ job preparedness [10] and integrated midwives into the wider healthcare system [11]
In this study of 38 nursing colleges/institutes in Bangladesh, in order to sustain midwifery education, we aim to identify a number of structural shortcomings that are indicative of the issues that many midwifery education institutions in many low-and middle income countries face
Summary
In order to promote sustainable midwifery education, it is important to understand what the structural shortcomings are. Bangladesh, with a current maternal mortality ratio of 173 per 100,000 live births and a neonatal mortality ratio of 17.1 per 1000 live births [5], has in recent decades rapidly scaled up its midwifery education system [4,6], increased its midwifery educator capability [7,8,9], improved students’ job preparedness [10] and integrated midwives into the wider healthcare system [11] All of this was done to meet the sexual and reproductive, maternal and newborn health needs of the country and to reach international health goals set by the UN. As a further step in this development process, in 2017 Bangladesh introduced a context-specific accreditation tool for accrediting midwifery education programs that met international quality standards [12]
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