Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe 1, 413 46, Gothenburg, Sweden.
Department of Obstetrics, Sahlgrenska University Hospital, Region Västra Götaland, Diagnosvägen 15, 416 50, Gothenburg, Sweden.
Hum Resour Health. 2020 Sep 17;18(1):65. doi: 10.1186/s12960-020-00510-x.
The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of the mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service is therefore critical. The aim of this study was to investigate midwives' challenges and factors that motivate them to remain in their workplace in the DRC.
Data were collected in two out of 26 provinces in the DRC through ten focus group discussions with a total of 63 midwives working at ten different healthcare facilities. Transcribed discussions were inductively analysed using content analysis.
The midwives' challenges and the factors motivating them to remain in their workplace in the DRC are summarised in one main category-Loving one's work makes it worthwhile to remain in one's workplace, despite a difficult work environment and low professional status-consisting of three generic categories: Midwifery is not just a profession; it's a calling is described in the subcategories Saving lives through midwifery skills, Building relationships with the women and the community, and Professional pride; Unsupportive organisational system is expressed in the subcategories Insufficient work-related security and No equitable remuneration system, within Hierarchical management structures; and Inadequate pre-conditions in the work environment includes the subcategories Lack of resources and equipment and Insufficient competence for difficult working conditions.
Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including (i) conducting midwifery education programmes following international standards, (ii) prioritising and enforcing policies to include adequate remuneration for midwives, (iii) involving midwives' associations in policy and planning about the midwifery workforce, and (iv) ensuring that midwives' working environments are safe and well equipped.
刚果民主共和国（DRC）的孕产妇死亡率高，助产士人数少，这破坏了 2030 年可持续发展目标（SDGs）中关于孕产妇和新生儿健康的目标 3 的实现。因此，扩大助产士队伍，提高医疗保健质量和服务留用率至关重要。本研究旨在调查刚果民主共和国助产士在工作中面临的挑战以及激励他们留任的因素。
通过在刚果民主共和国的 26 个省中的 2 个省的 10 个不同的医疗机构开展了 10 次焦点小组讨论，共有 63 名助产士参与。对转录的讨论进行了归纳分析，使用内容分析法进行分析。
刚果民主共和国助产士在工作中面临的挑战以及激励他们留任的因素总结为一个主要类别：“热爱自己的工作，尽管工作环境艰难，职业地位低下，但仍值得留在工作岗位上”，包含三个通用类别：助产不仅仅是一种职业，而是一种使命，包括以下子类别：通过助产技能拯救生命，与妇女和社区建立关系，以及职业自豪感；不支持的组织系统，包括以下子类别：工作相关的安全保障不足，没有公平的薪酬制度，在等级管理结构内；以及工作环境中的不足条件，包括以下子类别：缺乏资源和设备，以及缺乏应对困难工作条件的能力。
刚果民主共和国的助产士受到强烈职业道德的驱动，尽管工作环境艰难，职业地位低下，但仍为分娩妇女提供最好的护理。为了吸引和留住助产士，并确保他们能够充分发挥实践能力，我们建议在刚果民主共和国和其他面临类似挑战的低收入国家，在区域和国家层面采取协调行动，包括（i）按照国际标准开展助产士教育计划，（ii）优先和执行包括为助产士提供足够薪酬的政策，（iii）让助产士协会参与助产士队伍的政策和规划，以及（iv）确保助产士的工作环境安全且设备齐全。
