Exploring the perceptions of community midwives (CMWS) about their work experiences after deployment in the rural areas of Chitral, Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Nursing (MScN)


School of Nursing and Midwifery, Pakistan


Background Community midwives (CMWs) are the prime health care professionals, who can provide antenatal, intranatal, postnatal, and newborn care. In order to prepare and deploy CMWs, particularly in the rural areas, a project titled: Chitral Child Survival Programme (CCSP), funded by the USAID, in partnership with the Aga Khan Development Network (AKDN), was implemented in the remote areas of Chitral. CCSP is a larger study, being conducted over three years, and the midwifery team of AKU-SONAM is conducting operation research on the utilization of the CMWs' services. This thesis is based only on the deployment experience of the CMWs, as a part of the above mentioned larger study. Aim The aim of this study was to explore the perceptions of the CMWs about their work experiences after deployment in the rural settings of Chitral, Khyber Pakhtunkhwa, Pakistan. Methodology A qualitative descriptive design, using in-depth one-to-one semi-structured interviews of CMWs, was used. The interviews were conducted at the Aga Khan Health Services (AKHS), Chitral, Pakistan. Out of the 28CMWs who had been deployed in the first phase of the CCSP project, 13 participants were recruited for this study. The recruitment of the participants was stopped when data saturation was achieved. The interviews were audio-taped in the Urdu language, which were then translated into English. Data analysis was done concurrently with data collection by the study researcher, using Creswell's six steps.Findings Three major themes emerged as the findings of the study. These include: (1) rural CMWs' perceptions of their role and competencies, (2) facilitating and hindering factors related to the rural CMWs' ability to function, and (3) continuation of CMWs' services in the future. Recommendations Recommendations for rural midwives have been suggested both at the policy and practice levels. Additionally, this study emphasizes the need for improving midwifery practices in the rural community, with the involvement of the government and donor agencies at various platforms. Moreover, it has also been recommended that provision of supportive supervision should continue even after the closure of the CCSP project.

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