Being a midwife is being prepared to help women in very difficult conditions”: midwives’ experiences of working in the rural and fragile settings of Ituri Province, Democratic Republic of Congo

Baba, Amuda, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X, Martineau, Tim ORCID: https://orcid.org/0000-0003-4833-3149, Sabuni, P, Nobabo, NM, Alitimango, A and Raven, Joanna ORCID: https://orcid.org/0000-0002-4112-6959 (2020) 'Being a midwife is being prepared to help women in very difficult conditions”: midwives’ experiences of working in the rural and fragile settings of Ituri Province, Democratic Republic of Congo'. Rural and Remote Health, Vol 20, Issue 2, p. 5677.

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Abstract

Introduction: Maternal and neonatal health is a core focus area in fragile and conflict-affected states and midwives are key actors. But there is currently very little evidence on midwives’ experiences, the challenges that they face and coping strategies they employ in the challenging and fragile rural areas of Ituri region in the North-Eastern Democratic Republic of Congo. This understanding is critical to developing strategies to attract, retain and support midwives to provide vital services to women and their families. This study aims to explore midwives’ work experiences and challenges through time from initial professional choice to future career aspiration in rural Ituri Province, North-eastern DRC.
Methods: A qualitative approach using life history interviews with 26 midwives and 6 ex-midwives, and 3 focus group discussions with 22 midwives in 3 health districts of Ituri Province (Bunia, Aru and Adja) was conducted in 2017. Purposive sampling was used to recruit research participants. The transcripts were digitally recorded, and thematically analyzed using NVivo. A lifeline framework was deployed in the analytical process.
Results: Problem solving, child aspirations and role models were the main reasons for both midwives and ex-midwives to join midwifery. Midwives followed a range of midwifery training courses resulting in different levels and training experiences of midwives. Midwives face many work challenges: serious shortage of qualified health workers; poor working conditions due to lack of equipment, supplies and professional support; and no salary from the government. This situation is worsened by insecurity caused by militia operating in some rural health districts. Midwives in those settings have developed coping strategies such as generating income and food from farm work, lobbying local organizations for supplies and training traditional birth attendants to work in facilities. Despite these conditions, most midwives want to continue working as midwives or follow further midwifery studies. Family related reasons were the main reasons for most ex-midwives to leave the profession.

Item Type:	Article
Subjects:	WA Public Health > WA 20.5 Research (General) WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WQ Obstetrics > Childbirth. Prenatal Care > WQ 160 Midwifery
Faculty: Department:	Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.22605/RRH5677
Depositing User:	Jan Randles
Date Deposited:	22 Jun 2020 11:26
Last Modified:	22 Jun 2020 11:26
URI:	https://archive.lstmed.ac.uk/id/eprint/14767

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