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Researchers and health experts highlighted on Thursday (14 December) that countries relying more on midwives have effectively lowered maternal and child mortality rates. Current statistics indicate a 50 percent delivery rate in health facilities and an equal percentage at home.
However, findings reveal a concerning 28 percent occurrence of stillbirths during home deliveries.
Employing midwives has indeed led to a decrease in maternal mortality and an increase in normal births. However, a notable concern is the trend of midwives being employed as nurses in private institutions. Insufficient monitoring of the midwife program was underscored by government officials and researchers during a function held at a hotel in Gulshan in the capital, on Thursday.
- Bangladesh needs 22,000 midwives to help attain SDG 3 by 2030.
- Currently the country has 7,000 licensed midwives with only 2556 employed in government facilities
The Department of Nursing and Midwifery, along with the Brac James P Grant School of Public Health and the World Health Organisation, jointly organised the event titled “Transitioning to Midwifery Models of Care: Country Profile, Dissemination Events to Share The Advancements Made in Bangladesh”. The occasion marked the release of the assessment report on midwifery education and service conditions in the country.
Halida Hanum Akhter, a maternal health expert and senior associate at Johns Hopkins University, USA, emphasised that countries able to quickly employ midwives have demonstrated a faster reduction in maternal deaths. She revealed that 48 percent of pregnancies in the country are unwanted, contributing to an increase in abortion-related deaths.
She expressed concern over the fact that the process of delivery and the associated risks have remained unchanged for a decade. The abortion-related mortality rate has increased seven-times between 2010 and 2016.
The chief guest, Maksura Noor, Director General of the Midwifery Directorate, emphasised the need to employ 22,000 midwives to meet sustainable development goal 3 in health. Currently, the country has licensed 7,000 midwives, with 2500 serving in government hospitals and the remainder working in private facilities.
The initiative commenced a decade ago, resulting in the first midwife appointment in 2018. An additional 518 midwives are set to be appointed at district and divisional levels soon, while 5000 posts have been created for district, division, upazila and union facilities, complementing the creation of 10,000 midwife positions at family welfare centers (FWC).
She urged the authorities to mandate private hospitals and clinics to hire midwives and establish labour rooms in their facilities to attain SDG 3 by 2030. Because it has been found that 80 percent of the C-section takes place at the private clinics and hospitals.
Sharmina Rahman, Head of the Midwifery Program at Brac University, presented the report at the ceremony, noting significant progress despite the recent initiation of activities a few days ago in Bangladesh.
Sharmina Rahman highlighted that 2556 midwives are currently employed in government hospitals, but there's a concerning trend of them being assigned nursing roles in private institutions. She pointed out the absence of monitoring and evaluation in midwifery education and services. In a country where the maternal mortality rate remains significantly high, there is a target to reduce this rate to 70 lakhs by 2030. Many perceive this goal as challenging and requiring substantial effort.
Nizam Uddin, Director of the Maternal, Newborn, and Adolescent Health Program at the Department of Health, emphasised the importance of maternal mental preparedness for ensuring the birth of a healthy child. He noted that some individuals are hesitant to give birth in health centers due to concerns about surgery, lack of privacy, and fear of child theft. Additionally, some people think children can be exchanged with others at hospitals.
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