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The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study

BACKGROUND: An estimated 282 women die for every 100,000 live births in Myanmar, most due to preventable causes. Auxiliary Midwives (AMWs) in Myanmar are responsible for providing a package of care during pregnancy and childbirth to women in rural hard to reach areas where skilled birth attendants (...

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Autores principales: Than, Kyu Kyu, Tin, Khaing Nwe, La, Thazin, Thant, Kyaw Soe, Myint, Theingi, Beeson, James G., Luchters, Stanley, Morgan, Alison
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751822/
https://www.ncbi.nlm.nih.gov/pubmed/29298715
http://dx.doi.org/10.1186/s12889-017-5020-2
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author Than, Kyu Kyu
Tin, Khaing Nwe
La, Thazin
Thant, Kyaw Soe
Myint, Theingi
Beeson, James G.
Luchters, Stanley
Morgan, Alison
author_facet Than, Kyu Kyu
Tin, Khaing Nwe
La, Thazin
Thant, Kyaw Soe
Myint, Theingi
Beeson, James G.
Luchters, Stanley
Morgan, Alison
author_sort Than, Kyu Kyu
collection PubMed
description BACKGROUND: An estimated 282 women die for every 100,000 live births in Myanmar, most due to preventable causes. Auxiliary Midwives (AMWs) in Myanmar are responsible for providing a package of care during pregnancy and childbirth to women in rural hard to reach areas where skilled birth attendants (Midwives) are not accessible. This study aims to examine the role of AMWs in Myanmar and to assess the current practices of three proposed essential maternal interventions (oral supplement distribution to pregnant women; administration of misoprostol to prevent postpartum haemorrhage; management of puerperal sepsis with oral antibiotics) in order to facilitate a formal integration of these tasks to AMWs in Myanmar. METHODS: A mixed methods study was conducted in Magwe Region, Myanmar involving a survey of 262 AMWs, complemented by 15 focus group discussions with midwives (MWs), AMWs, mothers and community members, and 10 key informant interviews with health care providers at different levels within the health care system. RESULTS: According to current government policy, AMWs are responsible for identifying pregnant women, screening for danger signs and facilitating early referral, provision of counselling on nutrition and birth preparedness for women in hard-to-reach areas. AMWs also assist at normal deliveries and help MWs provide immunization services. In practice, they also provide oral supplements to pregnant women (84%), provide antibiotics to mothers during the puerperium (43%), and provide misoprostol to prevent postpartum haemorrhage (41%). The current practices of AMWs demonstrate the potential for task shifting on selected essential maternal interventions. However, to integrate these interventions into formal practice they must be complemented with appropriate training, clear guidelines on drug use, systematic recording and reporting, supportive monitoring and supervision and a clear political commitment towards task shifting. CONCLUSION: With the current national government’s commitment towards one AMW in one village, this study highlights the potential for shifting specific maternal lifesaving tasks to AMWs.
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spelling pubmed-57518222018-01-05 The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study Than, Kyu Kyu Tin, Khaing Nwe La, Thazin Thant, Kyaw Soe Myint, Theingi Beeson, James G. Luchters, Stanley Morgan, Alison BMC Public Health Research Article BACKGROUND: An estimated 282 women die for every 100,000 live births in Myanmar, most due to preventable causes. Auxiliary Midwives (AMWs) in Myanmar are responsible for providing a package of care during pregnancy and childbirth to women in rural hard to reach areas where skilled birth attendants (Midwives) are not accessible. This study aims to examine the role of AMWs in Myanmar and to assess the current practices of three proposed essential maternal interventions (oral supplement distribution to pregnant women; administration of misoprostol to prevent postpartum haemorrhage; management of puerperal sepsis with oral antibiotics) in order to facilitate a formal integration of these tasks to AMWs in Myanmar. METHODS: A mixed methods study was conducted in Magwe Region, Myanmar involving a survey of 262 AMWs, complemented by 15 focus group discussions with midwives (MWs), AMWs, mothers and community members, and 10 key informant interviews with health care providers at different levels within the health care system. RESULTS: According to current government policy, AMWs are responsible for identifying pregnant women, screening for danger signs and facilitating early referral, provision of counselling on nutrition and birth preparedness for women in hard-to-reach areas. AMWs also assist at normal deliveries and help MWs provide immunization services. In practice, they also provide oral supplements to pregnant women (84%), provide antibiotics to mothers during the puerperium (43%), and provide misoprostol to prevent postpartum haemorrhage (41%). The current practices of AMWs demonstrate the potential for task shifting on selected essential maternal interventions. However, to integrate these interventions into formal practice they must be complemented with appropriate training, clear guidelines on drug use, systematic recording and reporting, supportive monitoring and supervision and a clear political commitment towards task shifting. CONCLUSION: With the current national government’s commitment towards one AMW in one village, this study highlights the potential for shifting specific maternal lifesaving tasks to AMWs. BioMed Central 2018-01-03 /pmc/articles/PMC5751822/ /pubmed/29298715 http://dx.doi.org/10.1186/s12889-017-5020-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Than, Kyu Kyu
Tin, Khaing Nwe
La, Thazin
Thant, Kyaw Soe
Myint, Theingi
Beeson, James G.
Luchters, Stanley
Morgan, Alison
The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study
title The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study
title_full The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study
title_fullStr The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study
title_full_unstemmed The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study
title_short The potential of task shifting selected maternal interventions to auxiliary midwives in Myanmar: a mixed-method study
title_sort potential of task shifting selected maternal interventions to auxiliary midwives in myanmar: a mixed-method study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751822/
https://www.ncbi.nlm.nih.gov/pubmed/29298715
http://dx.doi.org/10.1186/s12889-017-5020-2
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