Challenges to implement evidence-based midwifery care in Bangladesh. An interview study with medical doctors mentoring health care providers

• Published in: Sexual & reproductive healthcare 2022-03, Vol.31, p.100692-100692, Article 100692
• Main Authors: Khatun, Monira, Akter, Parvin, Yunus, Samiha, Alam, Khairul, Pedersen, Christina, Byrskog, Ulrika, Erlandsson, Kerstin
• Format: Article
• Language: English
• Subjects: Bangladesh; Child; Content analysis; Female; Health Personnel - education; Humans; Infant, Newborn; Medical doctors; Mentoring; Mentors; Midwifery - education; Pregnancy; Qualitative Research
• ISSN: 1877-5756; 1877-5764; 1877-5764
• DOI: 10.1016/j.srhc.2021.100692

•Introducing evidence-based midwifery care in clinical practice is the first step towards quality maternal and newborn care.•Evidence-based midwifery practice is limited in Bangladeshi practice settings, resulting in student midwives not being able to put theory into practice.•Using medical doctors who were supportive of the role of the midwife, to mentor Health Care Providers in evidence-based practices was successful.•In a country where midwifery is an emerging profession, implementation of this model of mentorship is recommended. In 2013 the first midwives in Bangladesh to be educated according to international standards completed their course and were awarded a diploma. Sixty percent of their training took place in clinical placement sites. In order to achieve appropriate mentor support while in clinical practice, a mentorship programme was initiated whereby local doctors were appointed by Save the Children. The aim of this study is to describe the mentors’ purpose and the actions they took to improve midwifery care at clinical placement sites. Their appointment was intended to support local Health Care Providers (HCPs) at clinical placement sites meant for educating midwifery students in evidence-based midwifery care. An open-ended interview study with 14 mentors. The data was analysed using content analysis. The main category, the theme that emerged from the analysis was “Creating commitment”. “Creating commitment” describe how the mentors; the medical doctors employed by Save the Children, “Motivate”, “Educate”, “Mentor”, “Advocate” and “Communicate” (subcategories) to creating commitment for quality midwifery care “In the organization of care” and “In clinical care practices” (categories). As intended, they enabled HCPs, midwifery students, and newly graduated midwives to provide quality midwifery care. Using medical doctors’ status and power to support the development of a newly emerging midwifery cadre in a country where midwifery is just emerging as a profession is because midwives integrated in the health system will improve the birthing process, improve life chances for newborns, and reduce morbidity and mortality in Bangladesh. It is recommended for implementation in other similar national contexts.