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Social, economic and professional barriers influencing midwives’ realities in Bangladesh: a qualitative study of midwifery educators preparing midwifery students for clinical reality

Journal article
Authors Ulrika Byrskog
Hasne Ara Akther
Zohra Khatoon
Malin Bogren
Kerstin Erlandsson
Published in Evidence Based Midwifery
Volume 17
Issue 1
Pages 19-26
ISSN 1479-4489
Publication year 2019
Published at
Pages 19-26
Language en
Links https://search-proquest-com.ezproxy...
Subject categories Health Sciences


Identifying existing barriers inhibiting the provision of quality care in Bangladesh can guide both the government, in fulfilling its commitment to establishing the midwifery profession, and midwifery educators, in preparing midwifery students for the reality of midwifery clinical work. The aim of this study was to describe midwifery educators' perceptions of midwives' realities in Bangladesh, focusing on social, economic, and professional barriers preventing them from carrying out quality care. Data were collected through focus group discussions with 17 midwifery educators and analysed using qualitative content analysis, guided by the analytical framework "What prevents quality midwifery care?". Ethical clearance was obtained from Bangladesh's Directorate General of Nursing and Midwifery. The results generated by the application of the framework included social barriers of gender structures in Bangladeshi society. This influenced entry into midwifery education, carrying out midwifery work safely, and the development of the profession. Economic barriers included challenges for Bangladesh as a low-income country with a large population, inadequate salaries, and staffshortages, adding extra strain to midwives' working conditions. These social and economic barriers were further enhanced by professional barriers due to the midwifery profession not yet being fully established or acknowledged in the health system. The study presents novel country-specific perspectives but confirms the general underlying issues of gender inequality as a base for barriers preventing midwives from carrying out quality care, in line with the framework "What prevents quality midwifery care?". Addressing these structures can facilitate more students to enter midwifery education, enable quality midwifery work free from discrimination, and provide sufficient working space and professional integrity. Leadership training is pivotal to increasing responsiveness to the needs of the new cadre of midwives. Midwifery educators should take the lead in sensitising clinical supervisors, mentors, and preceptors about midwives' realities in Bangladesh

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