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

Baqui AH, El-Arifeen S, Darmstadt GL Effect of community-based newborn-care intervention package implemented through two service-delivery strategies in Sylhet district, Bangladesh: A cluster-randomised controlled trial. Lancet. 2008; 371:(9628)1936-1944

Campbell O, Calvert C, Testa A The scale, scope, coverage, and capability of childbirth care. Lancet. 2016; 388:(10056)2193-2208

Creswell J, 3rd edn. Thousand Oaks, California: Sage Publications; 2013

Dhakal S, Van Teijlingen E, Raja EA, Dhakal KB Skilled care at birth among rural women in Nepal: practice and challenges. J Health Popul Nutr. 2011; 29:(4)371-378

Dieleman M, Cuong PV, Anh LV, Martineau T Identifying factors for job motivation of rural health workers in North Viet Nam. Hum Resour Health. 2003; 1:(1)

Are The CMWs accessible in Punjab and Sindh. Research and Advocacy Fund. 2012. https://tinyurl.com/mgb768p (accessed 16 May 2017)

Halldorsdottir S, Karlsdottir SI The primacy of the good midwife in midwifery services: an evolving theory of professionalism in midwifery. Scand J Caring Sci. 2011; 25:(4)806-817

Homer CSE, Friberg IK, Dias MAB, ten Hoope-Bender P, Sandall J, Speciale AM, Bartlett LA The projected effect of scaling up midwifery. Lancet. 2014; 384:(9948)1146-1157

Hughes AJ, Fraser DM SINK or SWIM: the experience of newly qualified midwives in England. Midwifery. 2011; 27:(3)382-6

Ith P, Dawson A, Homer CS, Klinken Whelan A Practices of skilled birth attendants during labour, birth and the immediate postpartum period in Cambodia. Midwifery. 2013; 29:(4)300-7

Khan YP, Bhutta SZ, Munim S, Bhutta ZA Maternal health and survival in Pakistan: issues and options. J Obstet Gynaecol Can. 2009; 31:(10)920-929

Koblinsky M, Matthews Z, Hussein J Going to scale with professional skilled care. Lancet. 2006; 368:(9544)1377-1386

Kornelson J Rural midwifery: overcoming barriers to practice. Canadian Journal of Midwifery Research and Practice. 2009; 8:(3)6-11

Lugina HI, Johansson E, Lindmark G, Christensson K Developing a theoretical framework on postpartum care from Tanzanian midwives views on their role. Midwifery. 2002; 18:(1)12-20

Miller S, Abalos E, Chamillard M Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. Lancet. 2016; 388:(10056)2176-2192

Mohammad Y, Jan R, McIntyre H, Lakhani A, Anwar S, Levi AJ Community midwives workplace experiences: A case study from a resource-poor country. Br J Midwifery. 2015; 23:(12)886-93

Morrell C, Spiby H, Stewart P, Walters S, Morgan A Costs and effectiveness of community postnatal support workers: randomised controlled trial. BMJ. 2000; 321:(7261)593-8

Newburn M Evidence should enable informed decision making, not limit choice. Pract Midwife. 2012; 15:(4)

Nicholls L, Webb C What makes a good midwife? Implications for midwifery practice. Evidence Based Midwifery. 2006; 4:(2)65-70

NWFP and IUCN Pakistan. Chitral: An integrated development vision. 2004. http://cmsdata.iucn.org/downloads/chitral_idv.pdf (accessed 9 May 2017)

Prytherch H, Kakoko DC, Leshabari MT, Sauerborn R, Marx M Maternal and newborn healthcare providers in rural Tanzania: in-depth interviews exploring influences on motivation, performance and job satisfaction. Rural Remote Health. 2012; 12

Sarfraz M, Hamid S Challenges in delivery of skilled maternal care – experiences of community midwives in Pakistan. BMC Pregnancy Childbirth. 2014; 14:(1)

Singh S, Chhabra P, Sujoy R Role of traditional birth attendants (TBAs) in provision of antenatal and perinatal care at home amongst the urban poor in Delhi, India. Health Care Women Int. 2012; 33:(7)666-676

ten Hoope-Bender P, de Bernis L, Campbell J Improvement of maternal and newborn health through midwifery. Lancet. 2014; 384:(9949)1226-1235

Titaley CR, Dibley MJ, Agho K, Roberts CL, Hall J Determinants of neonatal mortality in Indonesia. BMC Public Health. 2008; 8:(1)

Titaley CR, Hunter CL, Dibley MJ, Heywood P Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia. BMC Pregnancy Childbirth. 2010; 10:(1)

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

United Nations. Transforming our world: the 2030 Agenda for Sustainable Development. Seventieth Session Report. 2015. https://tinyurl.com/z4o6pk4 (accessed 9 May 2017)

Van Lerberghe W, Matthews Z, Achadi E Country experience with strengthening of health systems and deployment of midwives in countries with high maternal mortality. Lancet. 2014; 384:(9949)1215-1225

Whelan A, Lupton P Promoting successful breast feeding among women with a low income. Midwifery. 1998; 14:(2)94-100

Geneva: WHO; 2015

Midwives' voices, midwives' realities report 2016.Geneva: WHO; 2016

World Bank. Health Indicators. 2015. http://data.worldbank.org/indicator (accessed 9 May 2017)

Exploring community midwives' perceptions of their work experience after deployment in the rural areas of Chitral, Pakistan

02 June 2017
Volume 25 · Issue 6

Abstract

Aims:

To explore the perceptions of community midwives about their work experiences after deployment in the rural settings of Chitral, Khyber Pakhtunkhwa, Pakistan.

Methods:

A qualitative descriptive approach was used, conducting in-depth semi-structured interviews with 13 community midwives.

Findings:

The three major themes that emerged from the analysis of the data were: (1) rural community midwives' perceptions of their role and competencies, (2) factors facilitating and hindering the rural community midwives' ability to function, and (3) continuation of community midwives' services in the future.

Conclusions:

The study findings highlighted the factors that empower and obstruct community midwives in providing services in rural areas. The majority of the community midwives felt empowered because of their increased earning capacity and enhanced competencies in performing their roles. However, some of them shared challenges in terms of socio-cultural and financial constraints. These findings have important implications for midwives working in rural areas.

Globally, the maternal mortality rate and neonatal mortality rate remain persistently high (World Bank, 2015). Globally, there are 216 maternal deaths per 10 000 live births every year. In South Asia, this rate is estimated as 180 maternal deaths per 100 000 live births, whereas in Pakistan maternal mortality rate estimates are 178 maternal deaths per 100 000 live births. Globally, the neonatal mortality rate is estimated as 19 deaths per 1000 live births, whereas in Pakistan it is estimated to be 46 deaths per 1000 live births (World Health Organization (WHO), 2015). The Sustainable Development Goals for 2016–2030 highlight the urgent need to work in economic, social and environmental dimensions, with 17 goals and 169 targets. The Sustainable Development Goals are hoped to be achieved over the next 15 years to tackle pressing challenges around the world (United Nations, 2015). According to Sustainable Development Goal 3, by 2030 the global maternal mortality rate should be reduced to less than 70 per 100 000 live births and the neonatal mortality rate to 12 per 1000 live births (United Nations, 2015).

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