Midwifery profession related challenges and issues
Midwifery profession related challenges has been raised in different regions at different places in the country. Some of these challenges and issues are different in their nature and sometimes they are specific to some regions. Ethiopian Midwives Association (EMwA) has been dealing with FMOH, RHB, FMACA and other stakeholders so as to mitigate and get solutions. Since the depths of the challenges are different and some of them are policy related, they need time to get solutions. EMwA as the only professional association of midwives will continue to present Midwifery profession related challenges to concerned bodies by organizing different meetings. The summarized question related to the profession were submitted prior to health professional forum meeting called by FMOH.
The summary of Midwifery profession related challenges are listed as follows:
There are regions where midwives are not allowed to work in the leadership position at woreda, zones and in the above structure. As a result supervision of obstetric service are being done by non-midwife supervisor.
Midwives will not be assigned to plan and lead MCH activities at woredas, zonal and regional level
All midwives were assigned to labor ward only and they are not allowed to work at ANC and FP unit. These kind of assignment to work only in labor ward and prohibiting to provide ANC and FP services in the facility has affected the profession morally.
(The above challenges were reported in different regions but most prominent in Amhara, Tigray, Oromia, SNNPR and Harari Regions)
The government has given educational opportunity for MSC on clinical midwifery in different universities but problems related to this professions are:
Those graduated with this profession (MSC in Clinical midwifery) are not working in their scope of practices since they are assigned in zonal and regional hospital where Gyn/OBs are working. This is leading midwives to change their profession.
Consideration is not given for master’s program that Gondar University prepared Neonatal health curriculum, but we didn’t go further due to different problems.
There is no proper benefit package for MSc professional midwives: The salary very small and as the same time there is no risk allowances.
Poor consideration MOH and EMwA on advocacy and work for the enrollment of midwives for emergency surgical officer training
There is no job descriptions for midwife and as a result midwives perhaps engaged other than their expected role in the health facilities.
Midwives are the only key actors in contributing to combat maternal and child health problem in the countries and due to the nature of Obstetric problem, midwives are the only profession who have obligation to live in health facilities for 24/7, pass overnight standing in delivery room, follow up laboring mother, travel with referred laboring mother in the night. With these and others workload, there is no motivational mechanisms for midwives, low benefit package which is not related with practice and also there no risk allowance.
Even if the Federal Ministry of Health recommended two midwives for one health center, there is only one midwife in most of the HC and as a result there is high workload and work burden. This situation is creating burnout and also has been a challenge on their social life.
The burden of work and risk allowances payments was not comparable
Payments of risk allowances is not uniform throughout the country. There are regions paying risk allowance but there are region doesn’t pay risk allowance.
Over time payments not properly paid in some areas specially weredas level.
Absences of representatives in medico legal committee at national and regional level and as a result most of the accused midwives did not get a legal advisory support
There is no midwifery care process as a result midwives are forced to fill nursing care process. Midwives are evaluated by nursing care process
Currently midwives are changing their profession because they are not allowed to open private clinic
Regional health bureau’s and Media personnel are not using the right nomenclature of the Midwife, so it needs more advocacy among media and regional health bureaus to use the right name of Midwife