Saving Lives of Mothers and Babies. An Assessment on Nurse-Midwives´ Knowledge in Bangladesh.

Introduction: Two women die every hour due to pregnancy and childbirth related complications in Bangladesh. It is well known that a strong midwifery profession is the key to achieving safer childbirth and it is the right of every woman to have access to a fully trained midwife and to a safe delivery. However this is not the case in Bangladesh. Today, the existing nurse-midwives are not fully utilized for the midwifery services. The profession is mal-distributed, functioning as multi-purpose service provider and are not recognized as a separate cadre of midwives. In relation to develop a six month additional Midwifery training for these nurse-midwives, it was therefore essential to get a better understanding about their current knowledge in the field of midwifery. Aim: The aim of this study was to assess the knowledge of the nurse-midwives providing midwifery services in twelve different health facilities in Bangladesh. Methodology: This baseline study was conducted at twelve different health facilities in Bangladesh, using a questionnaire adapted from Johns Hopkins University (JHPIEGO), Maternal Health Programs, Guidelines for Assessment of skilled providers and modified into the context of Bangladesh. It was a total of 38 respondents attending the survey and data was compiled and analyzed manually. Result: The assessment showed that the respondents had a vast gap in their knowledge of basic midwifery skills. The findings showed that the majority of them had a significantly low score of knowledge related to antenatal care, normal labour, and management of complications, childbirth and immediate newborn care as well as in post partum care. Discussion: The study demonstrated that the midwifery knowledge of the respondents did not fulfil the International standards based on International Confederation of Midwives (ICM) competencies. However, not only further training is needed, they need to be posted in a maternity unit to maintain their skills so therefore, creations of separate Midwifery posts are crucia

Midwifery Education, Reulation and Association in six South Asian countries - A descriptive study

Background: Countries in South Asia continue to have high maternal and newborn mortality rates. Midwifery has been broadly acknowledged as an evidence-based response to improving maternal and newborn health outcomes. Education, regulation and the establishment of an association are regarded as the foundation of strong and effective midwifery profession. Objective: The objective was to describe the situation of midwifery education, regulation and professional associations in six countries in South Asia. Methods: Data were collected via three questionnaires, constructed by the International Confederation of Midwives (ICM) and United Nations Population Fund (UNFPA) Investing in Midwives Programme, used at a Regional workshop in Bangladesh, 2010. The questionnaires included both closed and open-ended questions, and 55 out of 134 were selected for the purpose of this study. The data were analyzed with descriptive statistics and the open ended answers with a qualitative content analysis. Results: There was a variation in midwifery education across South Asia, in terms of entry level, competencies and requirements for teachers. None of the countries had national legislation that recognized midwifery as an autonomous profession. Four of the countries had a midwifery association. Main recommendations for improving formal midwifery education across the countries were: development of legislation, strengthened formal midwifery education, strengthened professional value, and an improved learning environment. Conclusion: South Asian countries in this study are working hard and have made some progress towards international standards. However, midwifery is not yet recognized as an autonomous profession. Only Afghanistan and Bangladesh had a curriculum based on ICM´s basic competencies. With further assistance, the area of South Asia will be able to create a midwifery workforce that complies with ICM’s global standards for midwifery education and regulation in order to provide high quality, evidence-based health service for women, newborn and childbearing families