Implementing midwifery services in public tertiary medical college hospitals in Bangladesh: A longitudinal study

Anderson, R. Eleanor; Williams, Anna; Hoque, Dewan Md Emdadul; Jess, Nicole; Shahjahan, Fatima; Hossain, Azmal; Bogren, Malin

doi:10.1016/j.wombi.2022.09.006

Cited by 8 publications

(9 citation statements)

References 21 publications

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“… 42 In many cases, midwives and mentors led the introduction of COVID-19 safety protocols for hospital triage systems and for establishing separate rooms for COVID-19 symptomatic mothers to receive ANC and deliver. 19 Before and after surveys of 91 hospitals with midwives showed significant improvements across all measures of COVID-19 readiness. 42 …”

Section: Establishing the Midwifery Profession In Bangladeshmentioning

confidence: 89%

“…17 Published research shows statistically significant increases in evidence-based birth practices (e.g., use of antenatal card and partograph, upright birth positioning, and skin-to-skin contact between mother and newborn) in public facilities that have midwives, indicating that midwives play a role in care quality improvement. 18 , 19 Based on World Health Organization (WHO) estimates for the needed human resources, 20 the Ministry of Health and Family Welfare (MOHFW) has approved 5,000 more midwifery posts, and an additional 20,000 are awaiting approval.…”

Section: Introductionmentioning

confidence: 99%

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Health System Strengthening Through Professional Midwives in Bangladesh: Best Practices, Challenges, and Successes

Begum,

Ara,

Islam

et al. 2023

Glob Health Sci Pract

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Section: Establishing the Midwifery Profession In Bangladeshmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Health System Strengthening Through Professional Midwives in Bangladesh: Best Practices, Challenges, and Successes

Begum,

Ara,

Islam

et al. 2023

Glob Health Sci Pract

Self Cite

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“…The bene ts of high-quality midwifery go well beyond saving lives. For example, evidence shows that midwives can: encourage health facilities to use evidence-informed care practices, [15] improve health equity, [27] and improve psychological safety. [28] Furthermore, studies have shown midwife-led care is capable of yielding results that are at least as good as other models of care at a lower cost.…”

Section: Discussionmentioning

confidence: 99%

“…[14] Another study found that the introduction of midwives to a hospital in Bangladesh led to improved quality of care for women and newborns. [15] A four-country study highlighted some universal enablers for the successful operation of midwife-led birthing centres. [16] Despite this body of evidence, many countries continue to rely heavily on a bio-medical approach, which treats all pregnancies and births as potentially pathological.…”

mentioning

confidence: 99%

Increasing the number of midwives is necessary but not sufficient: using global data to support the case for investment in both midwife availability and the enabling work environment

Nove,

Boyce,

Neal

et al. 2024

Preprint

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Background Most countries are off-track to achieve global maternal and newborn health goals. Global stakeholders agree that investment in midwifery is an important element of the solution. During a global shortage of health workers, strategic decisions must be made about how to configure services to achieve the best possible outcomes with the available resources. This paper aims to prompt policy dialogue and support this decision-making process. Methods Using the most recent available data from publicly available global databases for the period 2000–2020, we examined the association between the number of midwives per 10,000 population and: (i) maternal mortality, (ii) neonatal mortality, and (iii) caesarean birth rate in low- and middle-income countries (LMICs). We developed a composite measure of the strength of the midwifery profession, and examined its relationship with maternal mortality. Results In LMICs (especially low-income countries), higher availability of midwives is associated with lower maternal and neonatal mortality. In upper-middle-income countries, higher availability of midwives is associated with caesarean birth rates close to 10–15%. However, some countries achieved good outcomes without increasing midwife availability, and some have increased midwife availability and not achieved good outcomes. Similarly, while stronger midwifery service structures are associated with greater reductions in maternal mortality, this is not true in every country. Conclusions A complex web of health system factors and social determinants contribute to maternal and newborn health outcomes, but there is enough evidence from this and other studies to indicate that midwives can be a highly cost-effective element of national strategies to improve these outcomes.

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“…However, facility mentoring has constraints, including a shortage of skilled human resources, limited availability of experienced local mentors, and the need to provide ongoing mentoring support as opposed to one-time training [ 18 , 19 , 20 ]. It is essential for facility-wide activities to incorporate education and buy-in from facility managers and other healthcare service providers (e.g., doctors and nurses) regarding the roles of midwives and evidence-based SRMNAH practices [ 8 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Introducing Midwives and also Mentoring on the Quality of Sexual, Reproductive, Maternal, Newborn, and Adolescent Health Services in Low- and Middle-Income Countries: An Integrative Review Protocol

Anderson

Zaman

Limmer

2023

MPs

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Introduction: Midwives have the potential to significantly contribute to health-delivery systems by providing sexual, reproductive, maternal, newborn, and adolescent health (SRMNAH) care. However, scant research finds barriers to understanding what midwives need to realize their full potential. There are gaps in the definition of a midwife and an understanding of effective means to support the implementation of midwifery care. Mentorship has been found to support systems and healthcare providers to improve care availability and quality. Objectives: We describe the methodology of an integrative review that aims to generate evidence of the impact of introducing midwives and also on-site facility mentoring to better understand facilitators and barriers to implementation of the quality and availability of SRMNAH services in low- and middle-income countries (LMICs). Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be used to carry out the integrative review. Four electronic bibliographic databases, PubMed MEDLINE, EMBASE, Scopus, and CINAHL, will be used to identify eligible studies. All types of qualitative or quantitative studies will be considered. Eligible studies will be screened according to Population, Intervention, Comparison, and Outcome (PICO) inclusion criteria, and data will be extracted against a predetermined format. The aspects of health system strengthening in providing improved SRMNCH care will be examined in this review to generate evidence on how midwives and mentorship can improve routine care and health outcomes using the World Health Organization’s Six Building Blocks approach. The quality of the articles will be thematically analyzed in four areas: coherence and integrity, appropriateness for answering the question, relevance and focus, and overall assessment using the Gough weight-of-evidence framework. Expected results: The literature review will consider assessing both upstream health systems regulators and downstream effectors for implementing midwifery interventions. Within this building block framework, this research will report on the outcomes and experiences of introducing midwives and the effectiveness of mentoring midwives and other staff in midwives' roles in improving care quality and health outcomes.

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Implementing midwifery services in public tertiary medical college hospitals in Bangladesh: A longitudinal study

Cited by 8 publications

References 21 publications

Health System Strengthening Through Professional Midwives in Bangladesh: Best Practices, Challenges, and Successes

Health System Strengthening Through Professional Midwives in Bangladesh: Best Practices, Challenges, and Successes

Increasing the number of midwives is necessary but not sufficient: using global data to support the case for investment in both midwife availability and the enabling work environment

The Impact of Introducing Midwives and also Mentoring on the Quality of Sexual, Reproductive, Maternal, Newborn, and Adolescent Health Services in Low- and Middle-Income Countries: An Integrative Review Protocol

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