Abstract
BackgroundWith professional midwives being introduced in Bangladesh in 2013, the aim of this study was to describe midwifery students perceptions on midwives’ realities in Bangladesh, based on their own experiences.MethodData were collected through 14 focus group discussions that included a total of 67 third-year diploma midwifery students at public nursing institutes/colleges in different parts of Bangladesh. Data were analyzed deductively using an analytical framework identifying social, professional and economical barriers to the provision of quality care by midwifery personnel.ResultsThe social barriers preventing midwifery quality care falls outside the parameters of Bangladeshi cultural norms that have been shaped by beliefs associated with religion, society, and gender norms. This puts midwives in a vulnerable position due to cultural prejudice. Professional barriers include heavy workloads with a shortage of staff who were not utilized to their full capacity within the health system. The reason for this was a lack of recognition in the medical hierarchy, leaving midwives with low levels of autonomy. Economical barriers were reflected by lack of supplies and hospital beds, midwives earning only low and/or irregular salaries, a lack of opportunities for recreation, and personal insecurity related to lack of housing and transportation.ConclusionWithout adequate support for midwives, to strengthen their self-confidence through education and through continuous professional and economic development, little can be achieved in terms of improving quality care of women during the period around early and late pregnancy including childbirth.The findings can be used for discussions aimed to mobilize a midwifery workforce across the continuum of care to deliver quality reproductive health care services. No matter how much adequate support is provided to midwives, to strengthen their self-confidence through education, continuous professional and economic development, addressing the social barriers is a prerequisite for provision of quality care.
Highlights
With professional midwives being introduced in Bangladesh in 2013, the aim of this study was to describe midwifery students perceptions on midwives’ realities in Bangladesh, based on their own experiences
Economical barriers preventing midwifery quality care were reflected in the lack of supplies and hospital beds, midwives’ low and irregular salary and stipends, lack of opportunities for recreation, and personal insecurity related to lack of housing and transportation; whereof many are similar to those economic barriers previously reported in the framework by
Without adequate support for midwives, to strengthen their self-confidence through education and through continuous professional and economic development, little can be achieved in terms of improving quality care of women during the period around early and late pregnancy including childbirth
Summary
With professional midwives being introduced in Bangladesh in 2013, the aim of this study was to describe midwifery students perceptions on midwives’ realities in Bangladesh, based on their own experiences. In low-income countries, such as Bangladesh where resources are scarce, the provision of quality care around the time of childbirth is especially challenging [3], as it requires equitable access to educated, skilled, and motivated health professionals [4, 5] working in a functioning health system [3, 6]. With respect to the global priority where midwives are an important element of the health workforce, and seen as fundamental to the provision of quality care for women in early and late pregnancy and around childbirth [2, 7,8,9], the Government of Bangladesh has scaled up the availability of educated midwives into its health system [10].
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