Exploring the experiences of community midwives (CMWs) regarding their Department in District Matyari, Sindh, Pakistan

Date of Award

2013

Document Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

Department

School of Nursing and Midwifery, Pakistan

Abstract

Deploying Community Midwives (CMWs) within the community as Skilled Birth Attendants (SBAs) is nowadays, considered as the major intervention for achieving Millennium Development Goal (MDG) 4 to reduce Neonatal Mortality Rate (MNR) and MDG 5 to reduce Maternal Mortality Rate (MMR). In Pakistan, CMW, defined as SBA, is a person who conducts normal birth safely in the community, both at home and in the clinic. To promote consistent, efficient and effective deployment of these CMWs cum SBAs across the country, the Pakistan National Maternal Neonatal Child Health program (NMNCHP) asked the Technical Resource Facility (TRF) to develop a guideline. In order to understand the deployment experiences of the CMWs deployed as per these deployment guidelines, a qualitative descriptive study was planned by enrolling 11 deployed CMWs from district Matyari, Sindh, Pakistan. The data was collected through two focus group discussions, utilizing semi-structured interview guidelines. The findings revealed one major theme and five related categories, which include: lack of identity and recognition, state of helplessness, depletion of competence and male dominance, and unavailability of resources and finance support. These findings showed that surviving as CMWs was difficult in the community because the CMWs felt that they were not prepared well to fulfill the expected role in maternity services, independently. In addition, the management did not market the CMWs' role; nor did they stream line the processes for logistic and financial support. This showed implications for policy makers, to revise the CMWs' deployment guideline policies, specially, with regard to their introduction, marketing, and availability of resources, including the provision of supervision and remuneration. This revision seems to be necessary for sustaining the CMWs cadre, who are considered an important asset for achieving MDG 4 and 5. Key words: Community Midwives (CMWs), Deployment, Millennium Development Goals

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