Midwives in low-resource settings
Pakistan is a low-resource country where midwives are often not supported in their role as skilled birth attendants. Changes are needed to support midwives in providing safe and effective care.
Countries with scarce resources, like Pakistan, mostly have poor health indicators. Maternal, neonatal and child healthcare are often compromised as a result of a lack of availability and accessibility of trained birth attendants, such as midwives. Midwives are known to be the primary healthcare provider for women during the perinatal period. Generally, they face many challenges while working in communities; and being in a pandemic can worsen their problems. Pakistan has to apply possible strategies to promote the image of midwives and midwifery profession.
The Alma-Ata Declaration highlighted the importance of primary healthcare (World Health Organization [WHO], 1978). Countries across the globe developed action plans to strengthen the provision of primary healthcare services. Ten years later, the safe motherhood initiative was launched to promote perinatal care at community and healthcare facility level (Safe Motherhood, 1997). This initiative shifted the focus from traditional birth attendants towards skilled birth attendants. Skilled birth attendants are professionals, including midwives and obstetricians, who are trained to provide antenatal, intranatal, postnatal, and neonatal care, as well as family planning services to low risk women. Furthermore, they have to be competent in order to identify, manage and refer complicated maternal and neonatal cases to the appropriate levels of care in a timely manner (WHO et al, 2004).
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