Reproductive, maternal, newborn, child and adolescent health services in humanitarian and fragile settings

A mixed methods study of midwives’ and women’s experiences

Bibliographic Data

ID19591524
AuthorsT Dey (0000-0003-1326-5107, corresponding author), M G Shah (corresponding author), Aziz Baba (0000-0002-8032-1706, corresponding author), Ngatho Samuel Mugo (0000-0002-9300-788X, New South Wales Department of Health, corresponding author), Trude Thommesen (0000-0001-9723-4310, Stavanger University Hospital, corresponding author), Victoria Vivilaki (0000-0002-7111-481X, International Confederation of Midwives, corresponding author), Mathieu Boniol (0000-0003-1052-5604, World Health Organization, corresponding author), Noore Alam (0000-0002-1150-7582, The University of Sydney, corresponding author), Michael J Dibley (0000-0002-1554-5180, The University of Sydney, corresponding author), M Dibley, Dan Okoro (United Nations Population Fund, corresponding author), Petra Tenhoope-Bender (United Nations Population Fund, corresponding author), TH Triantafyllou (University of West Attica, corresponding author), Eleanor Langlois (0000-0002-4853-2511, corresponding author), E V Langlois
EditorsBijoya Roy (0000-0002-0859-9797)
Year2024
Volume4
Issue7
Pagese0003384
Publication date2024-07-03
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003384
PMID38959267
OpenAlexW4400275825
LanguageEN
Citations received3
References cited19

Insufficient progress has been made to reduce morbidity and mortality for women, children and adolescents particularly in Humanitarian and Fragile settings (HFS). Midwives play a critical and unique role in ensuring communities receive quality and safe essential sexual, reproductive, maternal, newborn, child, and adolescent health services. A lack of knowledge exists on the availability and experiences of midwifery services in HFS. This manuscript provides an overview of the midwifery density in HFS and a synthesis of the experiences of women receiving midwifery care, and barriers and facilitators for midwives providing essential SRMNCAH services in HFS. Guided by an expert committee, a concurrent mixed methods approach was applied, using secondary analysis of primary quantitative and qualitative data sources. Quantitative analysis of the global distribution of midwives compared to fragility was undertaken. Qualitative analysis of experiences of receipt and provision of midwifery care was undertaken across four settings providing humanitarian care. There is a critically low density of midwives in humanitarian and fragile settings. Sub-Saharan Africa accounts for the highest levels of fragility yet lowest density of midwives able to provide SRMNCAH services. Lack of finances both constrains midwives from effectively providing services and prevent communities from utilising services. Sub-optimal working conditions through rising workloads, insufficient and/or inconsistent resources were frequently reported to impede midwives from providing care in HFS. Uniquely for HFS, threats to the safety and security of midwives to conduct their work was widely reported. Key facilitators identified included, complex adaptive health system designs to respond effectively to the rapidly changing HFS environment, realisation of supporting “power, agency and status” as instrumental for midwives to provide quality care and promotion of community-centric approaches may enable continuity of care and uptake of essential SRMNCAH services. Midwives are critical to protect the health and well-being of communities. They require urgent protection and prioritisation in HFS areas where the need is greatest

Business · Environmental health · Health care · Obstetrics · Political science · Population · Qualitative research · Receipt · Reproductive health · Sociology · Global Maternal and Child Health · Maternal and fetal healthcare · Maternal and Perinatal Health Interventions · Medicine · Nursing · Psychology