Date of Award


Document Type


Degree Name

Master of Science in Nursing (MScN)

First Supervisor/Advisor

Dr. Rafat Jan

Second Supervisor/Advisor

Ms. Marina Baig


School of Nursing and Midwifery, Pakistan


Background: Midwives play a vital role in enhancing the quality of care and achieving substantial reductions in maternal and newborn mortality rates. However, in Gilgit Baltistan, the harsh winter weather and frequent heavy snowfall present distinct challenges for midwives providing essential maternal care. These challenges can lead to an increased risk of maternal infections and newborn hypothermia. Consequently, the limited accessibility to healthcare facilities due to frequent harsh winter weather and the resulting scarcity of resources like heating, electricity, and water exacerbate the situation.
Objective: The study aims to explore the challenges and barriers midwives face in maternity settings and the strategies they use to overcome those challenges during winter weather in the Northern Areas of Pakistan.
Methodology: The qualitative exploratory design was used in this study. A total of 9 midwives were purposely selected. Data were collected using individual semi-structured interviews and analyzed through qualitative content analysis.
Results: Five main themes emerged from the data analysis. These themes included; 1) Harsh Winters: Hindrances & Adversities. 2) Indigenous Strategies for Warmth and Wellness. 3) Coldness Jeopardizing Midwives" Well' Being. 4) Midwives' Resilience and Struggles: Harsh Winters. 5) Future Directions for Advancement.
Conclusion: Midwives experience numerous challenges in delivering maternal care, especially in remote areas with harsh winter conditions. Effectively addressing these challenges demands a comprehensive approach. This approach should include providing adequate resources and infrastructure improvements, including the prevention and management of hypothermia, the implementation of telemedicine services, the availability of dedicated emergency transport services, the establishment of maternity health centers in each remote area, and specialized training for midwives to enhance their capacity to handle winter emergencies, including cases of hypothermia.

Included in

Nursing Commons