References

Ali M, Bhatti MA, Kuroiwa C Challenges in access to and utilization of reproductive health care in Pakistan. J Ayub Med Coll Abbottabad. 2008; 20:(4)3-7

Anwar S, Jan R, Qureshi RN, Rattani S Perinatal women's perceptions about midwifery led model of care in secondary care hospitals in Karachi, Pakistan. Midwifery. 2014; 30:(3)e79-90 https://doi.org/10.1016/j.midw.2013.10.020

D'Ambruoso L, Achadi E, Adisasmita A, Izati Y, Makowiecka K, Hussein J Assessing quality of care provided by Indonesian village midwives with a confidential enquiry. Midwifery. 2009; 25:(5)528-39 https://doi.org/10.1016/j.midw.2007.08.008

2012. http://tinyurl.com/o9dpk3b (accessed 2 October 2015)

Garces A, McClure EM, Chomba E Home birth attendants in low income countries: who are they and what do they do?. BMC Pregnancy Childbirth. 2012; 12:(34) https://doi.org/10.1186/1471-2393-12-34

Global Alliance for Vaccines and Immunization. 2010. http://tinyurl.com/pf2pbsv (accessed 2 October 2015)

Government of Pakistan Ministry of Health. National Maternal Newborn and Child Health (MNCH) Programme 2006–2012. 2006. http://tinyurl.com/pl2z5x2 (accessed 14 October 2015)

Hafeez A, Mohamud BK, Shiekh MR, Shah SA, Jooma R Lady health workers programme in Pakistan: challenges, achievements and the way forward. J Pak Med Assoc. 2011; 61:(3)210-5

Hennessy D, Hicks C, Koesno H The training and development needs of midwives in Indonesia: paper 2 of 3. Hum Resour Health. 2006; 4

Homer CS, Friberg IK, Dias MA, Ten Hoope-Bender P, Sandall J, Speciale AM, Bartlett LA The projected effect of scaling up midwifery. Lancet. 2014; 384:(9948)1146-57 https://doi.org/10.1016/S0140-6736(14)60790-X

Hughes AJ, Fraser DM ‘SINK or SWIM’: the experience of newly qualified midwives in England. Midwifery. 2011; 27:(3)382-6 https://doi.org/10.1016/j.midw.2011.03.012

International Confederation of Midwives. Essential competencies for basic midwifery practice. 2013. http://tinyurl.com/q9vspz9 (accessed 2 October 2015)

Jafarey SN, Rizvi T, Koblinsky M, Kureshy N Verbal autopsy of maternal deaths in two districts of Pakistan––filling information gaps. J Health Popul Nutr. 2009; 27:(2)170-83

Kenya Ministry of Health. 2012. http://www.popcouncil.org/uploads/pdfs/2012RH_CommunityMidwiferyGuidelines.pdf (accessed 2 October 2015)

Khan YP, Bhutta SZ, Munim S, Bhutta ZA Maternal health and survival in Pakistan: issues and options. J Obstet Gynaecol Can. 2009; 31:(10)920-9

Koblinsky M, Matthews Z, Hussein J Going to scale with professional skilled care. Lancet. 2006; 368:(9544)1377-86

Krueger RA, Casey MAThousand Oaks, CA: SAGE Publications; 2000

Lalji L, Akbar Ali L, Baig M, Sewani R, Lakhani A, Kaufman K, Jan R Birth centre management and business skill training for community midwives of Pakistan. Journal of Asian Midwives. 2014; 1:(1)41-50

Maclean GD The challenge of preparing and enabling ‘skilled attendants’ to promote safer childbirth. Midwifery. 2003; 19:(3)163-9

2013. http://tinyurl.com/noluma7 (accessed 2 October 2015)

National Institute of Population Studies. 2008. http://dhsprogram.com/pubs/pdf/FR200/FR200.pdf (accessed 14 October 2015)

National Maternal, Newborn and Child Health Programme. Guidelines for the Deployment of Community Midwives. 2011. http://tinyurl.com/pko4u4u (accessed 2 October 2015)

Pakistan Nursing Council. 2006. http://tinyurl.com/p88tvb9 (accessed 16 November 2015)

Renfrew MJ, McFadden A, Bastos MH, Campbell J, Channon AA, Cheung NF, Silva DR, Downe S, Kennedy HP, Malata A, McCormick F, Wick L, Declercq E Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. Lancet. 2014; 384:(9948)1129-45 https://doi.org/10.1016/S0140-6736(14)60789-3

Rukanuddin RJ, Ali TS, McManis B Midwifery education and maternal and neonatal health issues: challenges in Pakistan. J Midwifery Womens Health. 2007; 52:(4)398-405

Saleem Z, Jan R, McInytre H, Rattani SA, Sikandar R Midwives' perception about their practice in a midwifery-led care model in Karachi, Pakistan. British Journal of Midwifery. 2015; 23:(3)200-7 https://doi.org/10.12968/bjom.2015.23.3.200

Sibley LM, Sipe TA Transition to skilled birth attendance: is there a future role for trained traditional birth attendants?. J Health Popul Nutr. 2006; 24:(4)472-8

Sarfraz M, Hamid S Challenges in delivery of skilled maternal care – experiences of community midwives in Pakistan. BMC Pregnancy Childbirth. 2014; 14:(1) https://doi.org/10.1186/1471-2393-14-59

Speakman EM, Shafi A, Sondorp E, Atta N, Howard N Development of the community midwifery education initiative and its influence on women's health and empowerment in Afghanistan: a case study. BMC Womens Health. 2014; 14:(111) https://doi.org/10.1186/1472-6874-14-111

Ten Hoope-Bender P, de Bernis L, Campbell J, Downe S, Fauveau V, Fogstad H, Homer CS, Kennedy HP, Matthews Z, McFadden A, Renfrew MJ, Van Lerberghe W Improvement of maternal and newborn health through midwifery. Lancet. 2014; 384:(9949)1226-35 https://doi.org/10.1016/S0140-6736(14)60930-2

Turkmani S, Gohar F Community Based Skilled Birth Attendants Programme in Bangladesh; Intervention towards Improving Maternal Health. Journal of Asian Midwives. 2015; 1:(2)17-29

Turkmani S, Gohar F, Zyaee PA, Musawi M, Azimi M Provision of Mentorship Services for Midwives Working in Remote Areas in the Workplaces of Afghanistan. Journal of Asian Midwives. 2014; 1:(1)12-16

United Nations Population Fund. 2014. http://www.unfpa.org/sites/default/files/pub-pdf/EN_SoWMy2014_complete.pdf (accessed 16 November 2015)

Van Lerberghe W, Matthews Z, Achadi E, Ancona C, Campbell J, Channon A, de Bernis L, De Brouwere V, Fauveau V, Fogstad H, Koblinsky M, Liljestrand J, Mechbal A, Murray SF, Rathavay T, Rehr H, Richard F, Ten Hoope-Bender P, Turkmani S Country experience with strengthening of health systems and deployment of midwives in countries with high maternal mortality. Lancet. 2014; 384:(9949)1215-25 https://doi.org/10.1016/S0140-6736(14)60919-3

Geneva: WHO; 1992

Geneva: WHO; 2004

World Bank. World Development Indicators. 2012. http://data.worldbank.org/sites/default/files/wdi-2012-ebook.pdf (accessed 14 October 2015)

Community midwives' workplace experiences: A case study from a resource-poor country

02 December 2015
Volume 23 · Issue 12

Abstract

Objective:

To explore community midwives' (CMs') experiences with respect to deployment policies and processes developed and used in Pakistan.

Methods:

A qualitative, descriptive, exploratory design was used; 11 CMs' perspectives were gained through two focus groups.

Results:

The findings are summarised under a key theme, ‘Surviving as community midwives', and four related categories: (1) lack of identity and recognition; (2) state of helplessness; (3) depletion of competence and confidence; (4) unavailability of resources and financial support.

Conclusion:

The study findings highlight the need for revising the deployment policies, especially those related to the preparation of CMs for working independently in communities; introducing the CMs and their roles within the communities; establishing independent work stations (birthing centres); and streamlining the remuneration processes. The findings recommend greater preparation of district and regional-level government officials by policy makers for the implementation of the new CMs' deployment plan.

In 2004, a joint statement issued by the World Health Organization (WHO), the International Confederation of Midwives (ICM) and the International Federation of Gynecology and Obstetrics (FIGO) identified skilled birth attendants (SBAs), such as midwives, as an effective intervention for achieving Millennium Development Goal (MDG) 4—to reduce the neonatal mortality rate (NMR)—and MDG 5, to reduce the maternal mortality rate (MMR). In 2006, the Lancet series further emphasised the use of midwives as SBAs (Koblinsky et al, 2006). More recently, the 2014 Lancet series evaluated midwives' contribution and recognised them as the backbone of maternal, neonatal and child health services, and a strong, cost-effective resource for preventing maternal and neonatal mortality (Ten Hoope-Bender et al, 2014; Homer et al, 2014; Van Lerberghe et al, 2014). The SBA is defined as a professional who has acquired midwifery skills through accredited training by a local nursing and midwifery board to assist woman safely throughout the birth process (Koblinsky et al, 2006).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month