Midwifery in Bangladesh: A brief introduction

BD Needs Midwife

Midwifery is relatively a new concept in Bangladesh. The traditional birth attendants commonly known as “Dhatri” are often mixed up with 'Midwives', whereas 'Midwifery' is an honorable and distinguished profession. A bit delayed compare to rest of the world, but Bangladesh has finally realized that the increasing number of professional midwives has a symbiotic relationship with the reduction of maternal and neonatal mortality rate. In the last decade, being a rising star among the Least Developing Countries (LDCs) and aiming to become a Developing Country, Bangladesh has shown strong commitment to end preventable child and maternal deaths by 2030 to achieve the Sustainable Development Goals (SDG).


To reach the goal the healthcare planners have prioritized antenatal and postnatal care, normal vaginal delivery, emergency obstetric care and new born care which directly links to quality maternal health services. Given the large number of maternity cases in Bangladesh, the country demands a huge supply of midwives to ensure healthy pregnancy for women and newborn. An estimated 22000 midwives will be required to meet the national need.

The Prime Minister of Bangladesh committed at the UN General Assembly Special Session in September 2010 to train 3000 midwives by 2015. To fulfil the commitment of the Honourable Prime Minister and to accelerate the production of midwives in the country, in January 2013, a three years direct entry Diploma in Midwifery Programme was introduced by the Government of Bangladesh under the 2011-2016 Health, Population and Nutrition Sector Development Programme (HPNSDP). Consequently, set up a strong curriculum, and reformed the relevant Directorate and the regulatory body ‘Bangladesh Nursing & Midwifery Council’ (BNMC), also created 3000 posts for midwives at health facilities. And recently 1150 licensed Midwives are posted at Upazila Health Complexes.

Midwife Walking in Rohingya Camp

 

To accelerate the production of midwives and introduce them in the remotest communities of Bangladesh, a three years direct entry Diploma in Midwifery Programme was introduced by the Government under the 2011-2016 Health, Population and Nutrition Sector Development Programme (HPNSDP) in January 2013. The programme started with intake of 525 students in 20 nursing institutes and was expanded, in phases to 925 students in 2016, across 38 institutes. A post-basic course was also started in 2010 under which 1,487 midwives have already been certified. Simultaneously with Government, midwifery education has also been expanded by the private sector.
To help reach country target, BRAC University (BRACU) launched 3-year ‘Diploma in Midwifery’ course in 2012 as the first midwifery education initiative in Bangladesh’s private sector. Funded by UK Government, the education initiative as part of the ‘Developing Midwives Project’ (DMP) looks to create around 1,200 midwives by 2021 in partnership with six renowned NGOS working in different corners of Bangladesh.

 

Midwife Rally

 

The most significant private sector initiative has been from BRACU which introduced a three years direct entry Diploma in Midwifery course in 2013 in partnership with 6 other NGOs targeted at vulnerable students from disadvantaged and hard to reach areas and provided free of cost to the students, through the support fromUK government. DMP promotes students from marginalized communities and low-income families. As of 2018, 256 students are from farmer families, 238 from families that depend on small-business, some from small job holders, such as, security guard, support service holders. DMP offers tuition waiver and merit scholarship to deserving candidates, and is gradually minimizing tuition. The plan for professional development of midwives is also the result of years of collaboration and relationship building among stakeholders such as the government, non-government organizations, academia, professional associations, United Nations Agencies and donors.

BRACU Sites in Bangladesh

Partners and location of BRAC University

The Developing Midwives project of BRAC University is being implemented in partnership with six other NGOs. Each site is called academic site. The project is run in seven Academic Sites across the country. Apart from the urban Academic Site in Dhaka, which is managed by BRACU directly, other six academic sites are in distant rural areas in five districts across the country. These Academic Sites are- Friends in Village Development Bangladesh (FIVDB) and Shimantik in Sylhet, Garo-Baptist Convention-Christian Health Project (GBC-CHP) in Mymensingh, Partners in Health and Development (PHD) in Khulna, World Mission Prayer League (LAMB Hospital) in Dinajpur and Hope Foundation in Cox’s Bazar.