The birth of midwives in Bangladesh
Despite significant progress in improving maternal mortality and reproductive health services inBangladesh (BMMS2010), serious short-falls remains in maternal health outcomes and access to services, particulary for poor women and in hard-to-reach areas. There is a growing international consensus on the critical role of midwives in reducing maternal and neonatal mortality and sustaining the same.
Recognizing the need for such a separate category of workforce and realizing the absence of any accredited education for midwives, the Prime Minister of Bangladesh committed at the UN General Assembly Special Session in September 2010 to train 3 000 midwives by 2015. This commitment is in relation to ensure round the clock access to the mdiwifery services in public health facilities. In taking this commiment forward, the Government of Bangladesh has placed this as a centre-piece for improving maternal, newborn and child health within in the Health Population and Nutrition Sector Development Plan (HPNSDP) effective from 1st of July 2011 to 30th of June 2016.
In Bangladesh, there are different levels of health care providers under DGHS and DGFP who give maternal, neonatal and child health/midwifery services. Presently, approx 27 000 nurse-midwives have been trained in general nursing combined with midwifery. However, none of them are trained according to the ICM/WHO standards of midwifery. At present a clear jobdesciption and deploymentplan are under development through the Government.
Within this context, and to improve the MNCH, a strategic direction on midwifery was developed and appoved by the Government and stakeholders in 2008. The Action Plan proposed:
Policy and Planning: Developement and implementation of strategies for effective utilization of midwives as an intergral part of the national human resource policy and workforce plan.
Training and Education: Strengthen midwifery knowledge and skills to perform quality maternal, newborn and child health care sevices as per assigned responsibilities through an additioinal 6- months post basic midwifery programme for nurse-midwives and developing a 3-yrs direct entry midwifery programme.
Deployment and Utilization: Based on workforce plan, deploy midwives to provide appropriate maternal and neonatal health services, and ensure supportive working environments.
Regulation: Review and update the regulations under BNC to enable the practice of midwives for midwifery services and to safeguard the public.
Bangladesh Midwives Education Regulation Society
To operationalize the strategic direction plan, a midwifery education programme was initiated by GoB, WHO and UNFPA in alignment with international and national standards to produce midwives with required competencies. To date, the 6-months post basic advanced training curriculum has been developed and education is ongoing. Six training institutes have been strengthened with training aids, faculty/teachers have been trained and 180 midwives certified in 2011. They are in the process of being deployed in sub-district health complexes across the country.
The training will shortly be scaled up with more training sites and increased faculty by 2015.
Simultaneously, the development of the 3-yrs diploma direct entry midwifery programme is under development and expected to be rolled out in 2012.
Regulation and deployment
Bangladesh Nursing Council is under the process to be reconstituted as the Bangladesh Nursing and Midwifery Council with separate boards for nurses and midwives. An Act for midwives have been formulated, created and will be approved by the Parliament. Directorate of Nursing (DNS) will be converted to include Midwifery.The Government will establish a recruitment rule, a clear job description and create 3000 new positions for midwives over the next five years.
Bangladesh Midwifery Society
The Bangladesh Midwifery Society was formed in August 2010 and has today over 260 members and an executive board of six certified midwives.
Objectives of the Bangladesh Midwifery Society
To educate midwives who possess knowledge and competencies at the national standard and relevant to societal needs.
To enhance the student to be a moral, accountable, self-directed and self-developed person who always provide quality midwifery services.
To utilize knowledge in developing peoples quality to life and midwifery profession.
To introduce the midwifery profession in health system and in the society effectively.
To ensure quelified midwifery services.
To enhance co-operation with national and international organizations.
To liaise with legislative and regulatory bodies to uphold the professional practice.
To promote research and development on midwifery services.