Author(s)

Iftikher Mahmood¹, Hannah Bergbower¹, Arman Mahmood¹, Annekathryn Goodman^2*

¹Hope Foundation for Women and Children of Bangladesh, Cox’s Bazar, Bangladesh.
²Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.

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.

Bangladesh, Maternal Mortality, Maternal Healthcare, Midwives, Midwifery, Midwifery Training, Cox’s Bazar, Adolescent Pregnancy, Pregnancy Outcomes, Medical Decision Making, Sexual Reproductive Healthcare, Hope Foundation

Mahmood, I. , Bergbower, H. , Mahmood, A. and Goodman, A. (2019) Maternal Health Care in Cox’s Bazar, Bangladesh: A Survey of Midwifery Experience at Hope Foundation and a Review of the Literature. Open Journal of Obstetrics and Gynecology, 9, 1624-1637. doi: 10.4236/ojog.2019.912158.