United Nations Population Fund, Dhaka, Bangladesh.
Liverpool School of Tropical Medicine, Liverpool, England.
Glob Health Sci Pract. 2023 Oct 30;11(5). doi: 10.9745/GHSP-D-23-00081.
In 2008, a cadre of professional midwives was introduced in Bangladesh. Since then, 120 midwifery educational programs have been established. There are 2,556 midwives serving at 667 government health facilities, and there are more midwives working in nongovernmental organizations and the private sector. This case study documents the process of establishing a midwifery profession with distinct midwifery expertise in Bangladesh and aims to guide other low- and middle-income countries in best practices and challenges. We describe the national administrative groundwork for the profession's launch, roll-out of an education program aligned with the International Confederation of Midwives, national deployment, enabling environments in deployment, and the professional association. Bangladesh's professional midwives' roles in humanitarian response and the COVID-19 pandemic are also discussed. The first and final authors were closely involved in supporting the government's establishment of the profession, and their direct experience is drawn upon to contextualize the topics. In addition, the authors conducted a desk review of documents that supported the profession's integration into the health system and documented its results. Both routine program data and existing research studies were reviewed. Outcomes show that midwives are deployed to 95% of government subdistrict hospitals. About 50% of these hospitals are fully staffed with 4 midwives, and within the hospitals, midwives are in charge of 90% of the maternity wards and attend 75%-85% of the births. Since the midwives' deployment, significant quality improvement for most World Health Organization indicators has been found, along with increases in service utilization. The experience of establishing a new midwifery profession in Bangladesh shows that it is possible for a lower middle-income country to introduce a globally standard midwifery profession, distinct from nursing, to improve quality sexual, reproductive, maternal, newborn, and adolescent health services in both humanitarian and development settings.
2008 年，孟加拉国引入了一批专业助产士。此后，建立了 120 个助产士教育项目。有 2556 名助产士在 667 个政府卫生机构工作，还有更多的助产士在非政府组织和私营部门工作。本案例研究记录了在孟加拉国建立具有独特助产专业知识的助产士职业的过程，旨在为其他中低收入国家提供最佳实践和挑战方面的指导。我们描述了该职业启动的国家行政基础，推出与国际助产士联合会一致的教育计划、国家部署、部署中的有利环境以及专业协会。还讨论了孟加拉国专业助产士在人道主义应对和 COVID-19 大流行中的作用。第一和最后一位作者都密切参与支持政府建立该职业，他们的直接经验被用来为主题提供背景。此外，作者还对支持该职业融入卫生系统的文件进行了桌面审查，并记录了其结果。审查了常规方案数据和现有研究。结果表明，助产士部署到 95%的政府分区医院。这些医院中约有 50%配备了 4 名助产士，并且在医院内，助产士负责 90%的产房并接生 75%-85%的分娩。自助产士部署以来，大多数世界卫生组织指标的质量都有了显著改善，服务利用率也有所增加。在孟加拉国建立新的助产士职业的经验表明，中低收入国家有可能引入一种与护理不同的全球标准助产士职业，以改善人道主义和发展环境中的性健康、生殖健康、孕产妇健康、新生儿健康和青少年健康服务的质量。
