Abstract
Background: The Ministry of Health and Family Welfare of the Government of Bangladesh developed a midwifery education strategy in 2011 and starting in 2013, BRAC University developed a three-year Diploma in Midwifery. A survey was developed to understand the challenges of the newly graduated midwives and to identify resource and educational needs. The survey feedback will help develop and strengthen curriculum for primary and postgraduate midwifery training. Methods: A 30-question survey was given to midwives at the Hope Hospital in Cox’s Bazar and at the birth centers in the surrounding rural communities. Questions explored the midwives’ clinical experience, patient problems in the prenatal, intrapartum, and postnatal period, and asked about what education; training and clinical resources were needed. Results: Thirty-two midwives answered the surveys. The midwives’ average time from graduation from the midwifery diploma program was sixteen months. All the respondents felt comfortable managing most maternal issues but felt further training was important. They also identified the lack of many clinical resources including blood products, medicines, vaccines, and ultrasound. They identified significant maternal health issues among their patients including adolescent pregnancy, malnutrition, anemia, sexual violence, pregnancy-induced hypertension, hemorrhage, low birth weight infants, prolonged and obstructed labors. Conclusion: Training and increasing the number of midwives are crucial strategies for reducing maternal and neonatal mortality. There is a significant need for long-term placement and commitment of midwives to rural areas in Bangladesh. Health systems and organizations employing midwives must be accountable for the continuing education, mentorship, and supportive needs of midwives.
Highlights
Bangladesh, a country of 170 million people, has an annual birth rate of 3.1 million [1]
Future studies must include careful documentation of diagnoses and short and long-term outcomes. This data is crucial for quality assurance and identification of sentinel events that can lead to changes in policies, medical protocols, and ongoing clinician training [41]. Our survey identified both sociodemographic factors of the patients such as adolescent pregnancy, malnutrition, and lack of medical decision making capacity and lack of clinical resources as major challenges for midwives working in the field
Improvement of maternal care can come from a bigger presence of midwives in sexual and reproductive healthcare
Summary
Bangladesh, a country of 170 million people, has an annual birth rate of 3.1 million [1]. A survey was developed to understand the challenges of the newly graduated midwives and to identify resource and educational needs. Questions explored the midwives’ clinical experience, patient problems in the prenatal, intrapartum, and postnatal period, and asked about what education; training and clinical resources were needed. All the respondents felt comfortable managing most maternal issues but felt further training was important They identified the lack of many clinical resources including blood products, medicines, vaccines, and ultrasound. They identified significant maternal health issues among their patients including adolescent pregnancy, malnutrition, anemia, sexual violence, pregnancy-induced hypertension, hemorrhage, low birth weight infants, prolonged and obstructed labors.
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