TITLE:
Maternal Health Care in Cox’s Bazar, Bangladesh: A Survey of Midwifery Experience at Hope Foundation and a Review of the Literature
AUTHORS:
Iftikher Mahmood, Hannah Bergbower, Arman Mahmood, Annekathryn Goodman
KEYWORDS:
Bangladesh, Maternal Mortality, Maternal Healthcare, Midwives, Midwifery, Midwifery Training, Cox’s Bazar, Adolescent Pregnancy, Pregnancy Outcomes, Medical Decision Making, Sexual Reproductive Healthcare, Hope Foundation
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.12,
December
31,
2019
ABSTRACT: Background: The Ministry of Health and Family Welfare of the
Government of Bangladesh developed a midwifery education strategy in 2011 and
starting in 2013, BRAC University developed a three-year Diploma in Midwifery. A
survey was developed to understand the challenges of the newly graduated
midwives and to identify resource and educational needs. The survey feedback
will help develop and strengthen curriculum
for primary and postgraduate midwifery training. Methods: A 30-question survey was given to midwives at the Hope Hospital in Cox’s
Bazar and at the birth centers in the surrounding rural communities. Questions
explored the midwives’ clinical experience, patient problems in the prenatal,
intrapartum, and postnatal period, and asked about what education; training and
clinical resources were needed. Results: Thirty-two midwives answered the surveys. The midwives’ average time from
graduation from the midwifery diploma program was sixteen months. All the
respondents felt comfortable managing most maternal issues but felt further
training was important. They also identified the lack of many clinical
resources including blood products, medicines, vaccines, and ultrasound. They
identified significant maternal health issues among their patients including
adolescent pregnancy, malnutrition, anemia, sexual violence, pregnancy-induced
hypertension, hemorrhage, low birth weight infants, prolonged and obstructed
labors. Conclusion: Training
and increasing the number of midwives are crucial strategies for reducing
maternal and neonatal mortality. There is a significant need for long-term
placement and commitment of midwives to rural areas in Bangladesh. Health
systems and organizations employing midwives must be accountable for the
continuing education, mentorship, and supportive needs of midwives.