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Research on the long-term impacts of trained midwives on health outcomes in Bangladesh

Narrative Description of Project:   The overall objective of the study was to understand the long-term impact or value added by the new midwifery cadre to maternal and new-born health in Bangladesh following their introduction to the health system. In addition, suggest suitable strategies to effectively develop, deploy and utilise them for better maternal and new-born health outcomes. A mixed methods approach was taken coupled with three different components. The first component was a policy analysis which included desk review, rapid horizon scanning and KIIs. The second component was a user survey, essentially a cross-sectional household survey involving the women with recent experience of receiving maternal health services (mothers with children less than 2 years of age) in the areas where the midwives were deployed. The last component was a study on midwives where both a quantitative survey and qualitative (Focus Group Discussions and case studies) methods were applied to explore the various aspects of the training, motivations, satisfactions and constraints and knowledge and skill of the midwives. Findings were presented to government stakeholders, particularly the Directorate General of Nursing and Midwifery (DGNM) and development partners in a workshop where possible solutions to challenges and ways forward were discussed in detail.

Description of Actual Services Provided by Mitra:

  • Details

    Ethical and government approval: Mitra is responsible to secure a local ethics approval from Institute of Health Economics of Dhaka University and it has been already secured.

     

    Sampling PSUs: Mitra has obtained the list of all the primary sampling units (PSU) of the selected upazilas including the number of households within the PSUs.

     

    Listing and sampling households: Mitra is responsible for listing all the households and collect GPS coordinates from each listed households in the sampled PSU. Listing is now going on. Once the listing is complete Mitra will sample the households from the PSU listing.

     

    Developing the survey instruments and data entry programme: OPM provided the draft survey instruments that Mitra reviewed and provided input to finalize it. The data entry programmer of Mitra is responsible for creating the data entry programme to be used in Computer Assisted Personal Interviewing (CAPI).

     

    Conduct focus group discussion and document case studies: Mitra is responsible for the qualitative research component which includes conducting 6 focus group discussions (FGD) with midwives and 10-12 case studies with documented transcripts. Both of these studies will have the same target group.

     

    Pretesting the survey tools: Mitra pretested the survey tools in a near-by rural community (not peri-urban) and provided detailed comments on the survey tools with suggested changes.

     

    Translation: Mitra translated the draft, revised and final data collection instruments.

     

    Training and piloting: Mitra will arrange the training venue and logistics and conduct the training. OPM consultants will be available during the training for technical support and provide any clarifications. After the training Mitra will also arrange for a piloting in a rural community outside the sampled PSUs.

     

    Data collection: Mitra will be responsible for managing the entire fieldwork. They will also arrange the accommodation, transport and other logistics for the field workers. As and when required, OPM consultants will provide technical guidance and suggestions during the fieldwork. Data will be collected in Computer Assisted Personal Interviewing (CAPI).

     

    Data cleaning: Mitra will be managing the data cleaning process and will be handing over the cleaned datasets to OPM. They will also deliver the transcripts for the FGDs and the case studies.

     

    Data analysis: Mitra will be analysing the quantitative datasets for the household survey and the midwifery survey.

     

    Qualitative data analysis and report: The qualitative enumerators of the team will write the transcripts of the qualitative interviews during the fieldwork. After the fieldwork they will do the coding

     

    Report writing: OPM will be leading the write-up of the main report. It is expected that the survey partner will provide input in various sections of the report.

    Name of Client and Contact Person:  Oxford Policy Management (OPM) Limited, Level 3, 52 Cornmarket Street, Oxford, OX1 3HJ, United Kingdom. Adiba Khaled, Consultant, Level 3, 52 Cornmarket Street Oxford, OX1 3HJ, United Kingdom, Email: adiba.khaled@opml.co.uk, Mobile:  +880 171 227 6080, Phone: +44 (0) 1865 207300, Fax: +44 (0) 1865 207301, Website: www.opml.co.uk.

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