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Scope of practice and workload of midwives in Bangladesh

Mother holding smiling baby

This research aims to determine the scope of practice and workload of midwives in Bangladesh, a low income country, enhancing understanding of their role.

It will identify areas of work where they lead or assist, and highlight their challenges and enablers. This information can then be used to inform the pre- and in-service education midwives receive and promote national discussion on empowering midwives and providing quality midwifery care.

The project has been highlighted as an important area for further study, both by CMNH and Centre for Injury Prevention, Health Development and Research (CIPRB, Bangladesh).

Data will be collected in two districts, one rural and one urban. 50 midwives will participate in the project, over a six month period. Objectives include:

  1. Identify who is a midwife in Bangladesh
  2. Map out the scope of practice of midwives working in Basic (BEmONC) and Comprehensive (CEmONC) Emergency Obstetric and Newborn Care facilities.
  3. Map out the workload, including the challenges and opportunities of midwives and nurse-midwives in designated functioning BEmONC and CEmONC facilities.

Background

The drive to reduce maternal morbidity has been hampered by the lack of skilled care and the critical shortage of qualified health workers, including midwives. International attention has promoted the use of skilled birth attendance (a health worker with midwifery skills present at every birth and transportation, in case of emergency). The recent publication, State of the World's Midwifery, has highlighted the challenges of providing midwifery services, strongly advocating that governments recognise midwifery as a distinct profession. With the advent of Universal Health Coverage, midwives will be central to continuing efforts to improve maternal and newborn health.

In Bangladesh, CMNH and CIPRB have collaborated for over six years, delivering the Making it Happen programme. This delivered country-specific training in:

  • Emergency Obstetric Care and Early Newborn Care (EOC & NC)
  • Strengthening data collection and use
  • Monitoring and evaluation of the interventions