Achievement Of Millennium Development Goals Research Articles

An analysis of cause-specific under-5 mortality in Bangladesh using the demographic and health survey 2011 and 2017–2018

BackgroundAs the Sustainable Development Goal 3.2.1 deadline (2030) approaches, rapidly reducing under-5 mortality (U5M) gains more prominence. However, initiatives or interventions that aided Bangladesh in achieving Millennium Development Goal 4 showed varied effectiveness in reducing certain cause-specific U5M. Therefore, this study aimed to examine the predictors of the key cause-specific mortalities.MethodsThis cross-sectional study was conducted using the Bangladesh Demographic and Health Survey 2011 and 2017-18 data. Cause-specific U5M was examined using multilevel multinomial mixed-effects analyses, and overall/all-cause U5M was examined using multilevel mixed-effects analyses. The respective estimates were compared.ResultsThe cause-specific analysis revealed that pneumonia and prematurity-related U5M were significantly associated with antenatal care and postnatal care, respectively. However, analysis of overall/all-cause U5M did not reveal any significant association with health services. Twins or multiples had a greater risk of mortality from preterm-related conditions (adjusted Relative Risk Ratio (aRRR): 38.01, 95% CI: 19.08–75.7, p < .001), birth asphyxia (aRRR: 6.52, 95% CI: 2.51–16.91, p < .001), and possible serious infections (aRRR: 11.12, 95% CI: 4.52–27.36, p < .001) than singletons. Children born to mothers 18 years or younger also exhibited a greater risk of mortality from these three causes than children born to older mothers. This study also revealed an increase in the predicted risk of prematurity-related mortality in the 2017-18 survey among children born to mothers 18 years or younger, children born to mothers without any formal education, twins or multiples and children who did not receive postnatal care.ConclusionsThis research provides valuable insights into accelerating U5M reduction; a higher risk of preterm-related death among twins underscores the importance of careful monitoring of mothers pregnant with twins or multiples through the continuum of care; elevated risk of death among children who did not receive postnatal care, or whose mothers did not receive antenatal care stresses the need to strengthen the coverage and quality of maternal and neonatal health care; furthermore, higher risks of preterm-related deaths among the children of mothers with low formal education or children born to mothers 18 years or younger highlight the importance of more comprehensive initiatives to promote maternal education and prevent adolescent pregnancy.

Barriers to clinical learning skills development among midwifery students and newly qualified midwives in Morocco: A qualitative study.

In Morocco, despite various initiatives to improve the quality of reproductive healthcare, the indicators remain unfavorable. To strengthen the skills of midwives and support the achievement of Millennium Development Goals (MDGs) 4 and 5 by 2030, Morocco has developed and implemented a competency-based training framework. However, there is a lack of information on the successful implementation of this program and its impact on the quality of student midwives' preparation for practice. This study aimed to gain a deeper understanding and explore the barriers affecting the development of clinical learning skills among midwifery students and newly qualified midwives. This study employed a descriptive, exploratory qualitative approach. Data were collected through nine focus group discussions with 30 midwifery students and 24 newly graduated midwives between April and June 2023 from six higher education institutions in northern and central Morocco. Inductive content analysis was used to analyze the transcribed discussions. The barriers varied between locations. Overall, the internship design was inadequate, and the clinical environment was insufficient. Participants highlighted limited opportunities to experience the full range of midwifery skills. However, most midwifery students and new graduates had deficient competencies in managing high-risk situations and emergencies. This work provides an overview of the nature and extent of the challenges faced by many student midwives in Morocco, resulting in newly graduated midwives being poorly prepared for the full range of midwifery practice. These findings can inform various initiatives to strengthen midwifery education at the global, regional, and national levels.

Analyzing the impact of an MDG-Fund program on childhood malnutrition in Timor-Leste

BackgroundTimor-Leste’s food insecurity, propelled by political conflicts, a fragile economy and biophysical limitations that characterize mountainous Small Island Developing States (SIDS), is expressed in a high incidence (50%) of stunted children. Hence, the Millennium Development Goals Achievement Fund’s Joint Program’s (MDG-F JP) in 2009 was a timely intervention to reduce prevalence of underweight among under-fives. Since the impact of the program remains largely unclear, the current study investigates the contributions of the MDG-F JP on improving children’s nutritional status in Timor-Leste, in order to inform policymakers on how to make future programs more effective.MethodsUsing bivariate analyses and multiple linear regression models we analyzed Demographic and Health Survey (DHS) data from under-fives in 2009–2010 and 2016, combined with spatially explicit data from geographic information systems (GIS). The analyses generated trends and factors associated with undernutrition, which were used in a quasi-experimental setting to compare districts that received the MDG-F JP with similar districts that did not receive MDG-F JP interventions.ResultsA comprehensive set of factors dependent on seasons, locations, and individuals determine undernutrition in Timor-Leste. A positive impact of the MDG-F JP was found for the average severity of wasting, but not for stunting and underweight.ConclusionsThe findings reinforce the pressing need for integrated and cross-sectoral programs, aimed especially at agricultural workers, mothers, and children. The agricultural challenge is to sustainably select, produce and conserve higher-yield and nutrient-rich crops, and educational enhancement should be aligned with local practices and research.

REDUCING MATERNAL MORTALITY VIA MIDWIFERY IN DISTRICTS JHANG AND KHANEWAL OF PUNJAB, PAKISTAN

Maternal mortality is one of the serious issues around the globe. About 800 expecting women die globally every day due to causes related to childbirth and pregnancy. One of the key reasons for the higher maternal mortality ratio in developing countries is the unavailability of skilled birth attendants. Pakistan, a low-income country, reported the highest Maternal mortality ratio (MMR), 186 deaths per 100,000 live births in 2019, which increased by 32% compared to the 2017 MMR. Despite all the efforts made by Pakistan, the country has made slow progress in achieving Millennium Development Goals (MDGs) 4 and 5; challenges of political fragility, complex security issues, and natural disasters made it more resistant. Our study used data from the recently established maternal, newborn, and child health program (MNCH) from two Districts in Pakistan. The study aimed to identify the efficient role of community health workers (CMWs) as home-based skilled service providers in reducing maternal mortality in two districts ( Jhang and Khanewal), Punjab, Pakistan. The study found that women are more likely to suffer from internal health issues despite the reasons many pregnant females (60%) had no antenatal visit during the first trimester of their pregnancy. Results indicated that examination through CMWs is more effective than the antenatal visit reported in health centers. It indicates the need to improve the skills and quality of home-based service providers’ facilitation and well-trained practice of instrument-assisted deliveries, especially by mid-level skilled birth attendants. Keywords: Maternal mortality, Midwifery, skilled birth attendants, MNCH Programme, antenatal

Convergence Analysis of Social Sector Expenditure and its Components: Evidence from the Indian States

ABSTRACT This paper examines the convergence of public expenditure and its major components using sub-national data from India. By employing the panel club convergence test, the paper finds convergence in per capita public expenditure across Indian states implying that distribution policies of public expenditure are effective and fair across the states. Subsequently, the convergence of per capita total social sector expenditure and its major components are studied. The results support the evidence of convergence for total social sector expenditures and in the case of its components, we find that six of the nine components display regional convergence. Three components, namely, per capita education, sports, art and culture expenditure; per capita social security and welfare expenditure; and per capita rural development expenditure display the evidence of divergence and the presence of multiple transition paths. From the policy perspective, these three components of social expenditures need greater attention by the state governments as these expenditures are important for social cohesion, sustainable development, and achieving millennium development goals.

Sensitivity and Positive Predictive Value of Child Death Certificates in Iran: A Cross-sectional Study

Background: Accurate information on the causes of child mortality is required to achieve Millennium Development Goal 4 (MDG4). The causes of child mortality are used to assess the pattern of diseases and make health policies. The accuracy of these mortality statistics depends on the proper completion of death certificates. Objectives: The study aimed to measure the sensitivity and positive predictive value (PPV) of death certificates obtained from the hospital information system (HIS) in a children's specialized hospital in Iran. Methods: This cross-sectional study assessed death certificates of 580 children of 1-59-month-old died in the hospital from 2011 to 2018. Pediatricians identified the minor and major errors and the underlying causes of death (COD). A misclassification matrix was used to measure agreement, sensitivity, and PPV using multiple causes obtained from death certificates and pediatrician reviews. Results: The HIS had a sensitivity of 43.27% and a PPV of 39.37%. The highest sensitivity was 73.33% for kidney diseases and urinary tract infections, and the lowest sensitivity was 18.18% for diarrhea and dehydration. The HIS had the highest PPV for accidents and injuries and the lowest PPV for diarrhea and dehydration (65.63% and 20.69%, respectively). The most identified underestimation and overestimation numbers were related to "respiratory disease and pneumonia" and "cardiac arrest", respectively. Conclusions: A large proportion of CODs in death certificates were registered inaccurately. The mortality statistics should be used with caution for planning and policy-making.

African’s Information and Communications Technology (ICT), Innovations and Economic Growth- Towards region integration: Empirical Evidence of Dynamic GMM Panel Data Approach.

Current literature on economic growth and development uniformly affirms the consensus that Information and Communication Technology ICTs (here defined as the composite index using 11 indicators as developed by (ITU)) is indispensable for economic growth and enhancing a wide range of development indices. It is common knowledge today that Information and Communication Technology (ICT) -whether embodied in human skills, capital goods, practices and organizations—are the key drivers of economic growth and sustainable development of nations and regions. The integration, growth and competitiveness of the economies of the East African Community (EAC) depend on Information and Communication Technology (ICT) and innovation.&#x0D; This paper examines the impact of Information and Communication Technology (ICT) use on economic growth using the Generalized Method of Moments (GMM) estimator within the framework of a dynamic panel data approach and applies it to five East Africa community Countries (EAC) countries over the period 2000 to 2018.The results indicate that there is a positive relationship between real GDP Growth and ICT Development index (as a composite index measured by the number of indicators which are, ICT readiness reflecting the level of network infrastructure and access to ICTs, ICT intensity reflecting the level of use of ICT in the society and ICT (skills) impact reflecting the result/outcome of efficient and effective ICT user). This implies that if these countries seek to enhance their economic growth, they need to implement specific policies that facilitate ICT development.&#x0D; The five Partner countries of the EAC should make closer cooperation strategies, systematic and significant regional integration arrangements in the generate and application of new knowledge and technological innovations, their ambitions to grow their economies, achieve Millennium Development Goals (MDGs) targets, deepen economic and political integration and attain sustainable development.

Does Tourism Affect Sustainable Development in MINT Countries?

Following the failure to achieve Millennium Development Goals by most countries in the world, Sustainable Development Goals are now at the center of developmental issues. Consequently, this study aims to examine if tourism can be an ally to sustainable development in MINT (Mexico, Indonesia, Nigeria, Turkey) countries between 1995 and 2018. The study uses adjusted net saving and international tourism receipts in these countries as measures of sustainable development and tourism, respectively. In achieving its objectives, the study employs the augmented mean group (AMG) estimation technique to estimate the long-run parameters. Besides, mean group (MG) and common correlated effects MG techniques are employed to check the robustness of the estimates obtained via the AMG approach. The results from the three estimators show that tourism is indeed an ally to sustainable development in MINT countries since there is a significant positive relationship between tourism and sustainable development. In other words, tourism can put the MINT countries on the path to sustainable development. This implies that any policy that will enhance the performance of the tourism industry will ensure sustainable development in MINT countries. Thus, the governments of MINT countries should focus basically on achieving sustainable tourism development, as this will translate to sustainable development in their countries.

Challenges in Primary Level Inclusive Education in Bangladesh

Bangladesh’s step towards inclusive education was given incentive by its involvement in major international declarations. Bangladesh agreed with the declaration of Education for All, in which education is to be provided to all children with an inclusive approach. In addition, Bangladesh is also committed to achieve Millennium Development Goals, which articulated the rights of all children into education through uniform system. It is important to note that the trend of enacting inclusive education policy and legislation in Bangladesh is mainly based upon the international treaties. The purpose of this paper is to highlight challenges in inclusive education for the policy formulators, implementers, and future researchers to take measures accordingly to universalize inclusive education in the country. The challenges identified in inclusive education concerned unfulfilled requirements of children with special needs, unfriendly situation, inadequate material and non-conforming curriculum, misinterpretation and mismanagement by stakeholders, restricted political and social backing, and adverse physiography. Pre-service training of teachers, along with continued assessment, collaboration and coordination to overcome challenges of inclusive schooling is recommended.

Effect of COVID-19 on maternal and neonatal healthcare services in Guinea: a hospital based study

ObjectiveThe objective of this study was to analyze the effect of COVID-19 on routine maternal and newborn health services in three referral facilities in Guinea.MethodsThis was a cross-sectional study using routine facility data covering two years (2019-2021). COVID-19 effects were quantified using interrupted time series models. The use of services (intra-hospital deliveries and neonatal admissions) and outcomes (obstetric complications and neonatal deaths) were analyzed for the periods before (March 2019-February 2020), and during (March 2020-February 2021) the COVID-19.ResultsThe mean number of monthly deliveries did not vary significantly before and during COVID-19 but that of induced labor increased significantly during COVID-19 (p < 0.001). Also, the monthly mean of neonatal admissions significantly decreased during COVID-19 (167 versus 124; p < 0.001). The mean number of monthly hospitalizations significantly decreased (123 before COVID-19 versus 87 during; p = 0.001). The mean number of monthly neonatal admissions in the pre-COVID-19 period significantly increased. Immediately after the start of the epidemic in Guinea (March 12, 2020), admissions declined significantly (64 admissions, 95%CI 102-27; p = 0.001). The mean number of monthly maternal deaths increased significantly during the pandemic (p = 0.002), as did the number of babies with low birth weight (p = 0.04). In the pre-COVID-19 period, there was a monthly increase of three neonatal deaths (95%CI 1.5 - 4; p = 0.001) but from the start of COVID-19, the monthly trend declined significantly and continued throughout the COVID-19 period (5 deaths/month, 95%CI 7-3).ConclusionsThe ongoing COVID-19 pandemic is jeopardizing efforts to achieve Millennium Development Goals for maternal and child health in urban settings in Guinea. For the country's health system to be resilient to crises such as COVID-19, there is a need for interventions to ensure the continuity of maternal and neonatal care.Key messages COVID-19 decreased monthly hospitalizations but increased maternal deaths in big urban maternities in Guinea.COVID-19 decreased neonatal admissions and deaths but increased low birth weight in referral neonatal units in Conakry, Guinea.

Women Health Problems Concern with Maternity in India

Women play important role in maintaining health of families, so more efforts are required to maintain women health. Women having health problem like anaemia, reproductive health, infection etc. Government of India introduced lot women health care policy and schemes to tackle the problem of women health improvement in India. But we are far behind in achieving Millennium Development Goal (MDG) of women's health, till date and therefore Women need a special care.

Harnessing cultural heritage for sustainable development: an analysis of three internationally funded projects in MENA Countries

ABSTRACT The importance of cultural heritage as an enabler of sustainable development is widely acknowledged. However, its role has remained marginalised in past and current international development agendas. This paper provides an original interdisciplinary study interrogating the potential of harnessing cultural heritage (both tangible and intangible) for sustainable development. It also reflects on how international policies and narratives on cultural heritage for development have been implemented on the ground. In particular, it critically examines the contribution of cultural heritage to worldwide developmental issues, with an approach that traverses the three sustainable development dimensions. It investigates how cultural heritage has been used to tackle global challenges, such as poverty alleviation in marginalised groups (economic dimension); gender equality and the empowerment of women (social dimension); and environmental sustainability (environmental dimension). The analysis focuses on three heritage for development projects funded through the ‘Millennium Development Goals Achievement Fund’, jointly implemented by UNESCO in partnership with other United Nations organisations and local partners in the Middle East and North Africa between 2008 and 2013. The article sheds light on multifaceted aspects of cultural heritage for sustainable development by discussing key achievements and common pitfalls.

An Evaluation of the Effectiveness of Communication Strategies for Achieving Millennium Development Goals in Zambia

According to various reports by the UN and other organizations, Africa is facing big challenges in achieving the world's anti-poverty Millennium Development Goals (MDGs). This prompted a study by Muleba Matafwali (2010) which aimed at enhancing the understanding that communication plays a very critical role in the quest to attain development in Zambia. Key findings were that Twenty-Five point Five percent (25.5%) of the respondents indicated that television and radio documentaries were the most useful tool sources of information on MDGs for them. Forty-Three point Six percent (43.6%) indicated that community education on MDGs should be intensified. A total of 16.4% of respondents indicated that radio and television programmes should be prioritized in an effort to accelerate the achievement of MDGs. The findings also revealed that MDG experts and politicians make up 19.1% and 18.2% respectively of people who were good sources of information for them. A total of 126 people were sampled for the study. In the conclusion, the study noted that all key players in the MDG campaign were making significant efforts to reach the wider public with the MDG message. However there was need to accelerate these efforts in order to reach the wider population. The study recommended that MDG campaigners should use more inexpensive communication methods such as folk media alongside conversional means of communication such as radio.

Analysis of the effect of health insurance on health care utilization in Rwanda: a secondary data analysis of Rwandan integration living condition survey 2016-2017 (EICV 5)

Introduction: health insurance is an insurance policy that guaranteed that you receive cashless therapy or reimbursement of expenses in case you become ill. Rwanda has made extensive positive aspects in the health and welfare of its population over a fairly quick period of time, along with standout achievement of Millennium Development Goals (MDGs). However, today health insurance has expanded compared to previous years, with this success health services become more accessible. Despite a high rate of enrollment of health insurance in Rwanda, the universal health coverage is not yet achieved. In addition to this, little has been done to analyze the effect of health insurance on health care utilization.

Women in Education sector: Monitoring and Evaluation of the Impact of Education Policies on Women Empowerment

One of the perspectives of delving women in academia is by using Sustainable Development Goal (SDG) goal 4 ‘Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all’, to measure the SDG number 5, ‘Achieve gender equality and empower all women and girls’ - and the vice versa. The extent of Millennium Development Goals (MDGs) realization provides lessons that the current and future education policies and programs are/ will be founded on. To achieve a thorough analysis, consistently accurate and relevant data is requisite and essential to monitoring and evaluating the real effects of education policies on women empowerment. At a glance, the average children enrolment in primary education rose remarkably between 2000-2015 in most developing countries indicating the extent of achievement of MDGs. Shifting from these quantitative evaluation results, this study outlines qualitative perspectives of measuring women in leadership in the education sector as an approach of empowerment. A key concern is how the generation of data through monitoring and evaluation enables fast-tracking of the effects of the policies on women empowerment in the education system. In this article, we focus on three school management variables as measures of women empowerment: 1) the nature of both internal and external audits to ensure accountability and transparency; 2) professionalism enhancement (nature of the In-service education training), and 3) the analysis of resource needs in empowering women. While doing the monitoring and evaluation of SDGs achievement, there is a need to deepen the analysis and consider the processes that determine which gender elevates to leadership.

Disruptive technological innovations in construction field and fourth industrial revolution intervention in the achievement of the sustainable development goal 9

Innovation has been described as a vehicle of development. This research therefore address the question of relevance of fourth industrial revolution in providing backbone for disruption that could make sustainable development goal 9 achievable. The purpose of the study is to marry the intervention of disruptive innovation within the context of fourth industrial revolution and how it could help achieve SDG goal 9. Quantitative approach was used in carrying out the research while random sampling technique was used to pick samples randomly across the study area. Sample frame of 100 was picked while sample size of 50 samples was picked from the population frame. Questionnaire designed in Likert scale 1–5 was used for the study. The following results were presented, the need for disruptive innovation in construction field, state of disruption in construction operation in construction industry, factors affecting technological disruption [td], level of awareness of disruptive technology in the built environment, critical success factor in application of disruptive technologies, major drivers of disruptive innovations in construction industry and their functionalities. The study later proposed route for deployment of disruptive application in sustainable construction and achieving millennium development goal through disruptive innovations. Disruptive innovation is the key to desired technological development.

Challenges of Allied Healthcare Professionals in India–Establishing the Council is Need of the Hour

There is a supply-demand gap of about 65 lakh allied health professionals in India. With India facing aheavy burden of disease with many challenges as achieving millennium development goals, shortage ofskilled manpower will be a great hurdle for the health care delivery system. In such a situation, AlliedHealth workers can play a major role in providing holistic health services to the community. Though manyinstitutions or Universities in India are generating allied healthcare professionals, there is no uniformityin the outcome of such professionals. There is no standardization of this professional till date. Hence, toestablish a Centralized council is a need of an hour so that all such programs will come under a commonplatform and generated manpower will be able to provide the necessary services to the community. Inthis article, some suggestions are provided to improve the quality of AHPs, like estimation of workforceaccording to WHO requirement, uniformity in curricula, common nomenclature for all programs, creatingjob opportunities in private and public sectors etc.

Abandonment of Patient in Emergency Department of Tertiary Care Hospital of Eastern Nepal – a Case Study

Introduction: With increasing of workload of emergency room employees, many of the community’s emergency hospitals are now facing another challenge, i.e. the abandonment of patient in emergency Department. It seems undesirable in most hospital service settings due to loss of revenue and ill-will. The hospital’s staffs feel that they have no option but to keep those sufferers until a further plan can be made. It presents a dilemma for the staffs of Emergency and for the hospital administrators as well. The current case report presents an abandoned patient in Emergency Department of B. P. Koirala Institute of Health Sciences (BPKIHS).&#x0D; Case Report: A 70-year old male brought by police and was left abandoned in emergency ward of BPKIHS in altered conscious state. The patient was managed in emergency ward with conservative management nearly for six weeks.&#x0D; Conclusion: The problem is multidimensional, is in conflict of the concept towards achievement of Millennium Development Goals (MDGs) and a challenge to social security.

Increasing utilisation of perinatal services: estimating the impact of community health worker program in Neno, Malawi

BackgroundBy 2015, Malawi had not achieved Millennium Development Goal 4, reducing maternal mortality by about 35% from 675 to 439 deaths per 100,000 livebirths. Hypothesised reasons included low uptake of antenatal care (ANC), intrapartum care, and postnatal care. Involving community health workers (CHWs) in identification of pregnant women and linking them to perinatal services is a key strategy to reinforce uptake of perinatal care in Neno, Malawi. We evaluated changes in uptake after deployment of CHWs between March 2014 and June 2016.MethodsA CHW intervention was implemented in Neno District, Malawi in a designated catchment area of about 3100 women of childbearing age. The pre-intervention period was March 2014 to February 2015, and the post-intervention period was March 2015 to June 2016. A 5-day maternal health training package was delivered to 211 paid and supervised CHWs. CHWs were deployed to identify pregnant women and escort them to perinatal care visits. A synthetic control method, in which a “counterfactual site” was created from six available control facilities in Neno District, was used to evaluate the intervention. Outcomes of interest included uptake of first-time ANC, ANC within the first trimester, four or more ANC visits, intrapartum care, and postnatal care follow-up.ResultsWomen enrolled in ANC increased by 18% (95% Credible Interval (CrI): 8, 29%) from an average of 83 to 98 per month, the proportion of pregnant women starting ANC in the first trimester increased by 200% (95% CrI: 162, 234%) from 10 to 29% per month, the proportion of women completing four or more ANC visits increased by 37% (95% CrI: 31, 43%) from 28 to 39%, and monthly utilisation of intrapartum care increased by 20% (95% CrI: 13, 28%) from 85 to 102 women per month. There was little evidence that the CHW intervention changed utilisation of postnatal care (− 37, 95% CrI: − 224, 170%).ConclusionsIn a rural district in Malawi, uptake of ANC and intrapartum care increased considerably following an intervention using CHWs to identify pregnant women and link them to care.

Experiences of Midwives for Caring Unbooked Pregnant Mothers in a Maternity Unit at a District Hospital in the Eastern Cape Province

Background: South Africa struggles to improve maternal health outcomes resulting to its failure to achieve millennium development goal for maternal health. Non-utilisation of antenatal health services by pregnant mothers is the leading cause of unbooked cases that complicate the labour stages. Purpose: The purpose of the study was to explore the experiences of midwives for caring unbooked pregnant women in a maternity unit at a district hospital in the Eastern Cape province of South Africa. Design and Methods: A phenomenological approach was adopted in this study. Specifically, a descriptive phenomenological deign was used to explore midwives’ experiences for caring unbooked pregnant women in maternity ward of a district hospital on six (6) purposively selected midwives. In this study, the researcher utilised individual, semi structured phenomenological interviews to collect data from midwives caring for unbooked pregnant mothers in a maternity unit. Data saturation was reached after carrying out the six interviews. These interviews were audio taped and transcribed verbatim and Interpretative Phenomenological Analysis framework steps method of qualitative data was applied to analyse the collected data. Results: Three thematic categories emerged from data analysis: 1) Experiences of midwives, which interfered with emotional challenges leading to fear and anxiety. Experiences of midwives were also associated with shortage of midwives and leading to maternal incidences. 2) Caring for unbooked pregnant mothers interfered with incompetency and inexperienced midwives and reported a lack of debriefing. 3) Support system which was seen as lacking from managers. Conclusion: The study recommended collaboration with primary health care clinics including community leaders, and employment of highly skilled professionals and in-service trainings of the current midwives to minimise unnecessary incidences.