I have often said that while my immediate focus is to combat birth-related infections in remote villages in Southern Laos, my longer term goal is to fund midwifery training. But how do you ensure that midwives trained in the relative prosperity and comfort of the capital Vientaine return to their villages? This study examines this exact issue in Ghana and reveals that it’s not easy.
The staffing of public sector health facilities in remote rural areas is a serious challenge for many ministries of health in low- and middle-income countries.
Results
Three themes were identified through a broad inductive process: 1) social amenities; 2) professional life; and 3) further education/career advancement. Together they create the
overarching theme, quality of life, we use to describe the influences on midwifery students’ decision to accept a rural posting following graduation.Conclusions
In countries where there are too few health workers, deployment of midwives to rural postings is a continuing challenge. Until more midwives are attracted to work in rural, remote areas health inequities will exist and the targeted reduction for maternal mortality will remain elusive.
As an aside, I am shocked to see that Ghana actually has much better maternal and infant stats than Laos (400 per 100k, 80% give birth alone, 27% antenatal care):
Maternal death in Ghana is currently estimated at 350 per 100 000, in part a reflection of the low rates of skilled support during birth [13]. According to the Demographic Health Survey,
43% of Ghanaian women give birth alone or with a non-skilled attendant [14] although 62.8% of women surveyed had attended the minimum standard of four antenatal visits [15].
Leave a Reply