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Lund University (2021)

"We need to be the ones driving the change for Women’s and Children’s health” - A case study on Midwife-led care in Ethiopia, Kenya, Malawi and Somalia

Blomgren, Johanna

Titre : "We need to be the ones driving the change for Women’s and Children’s health” - A case study on Midwife-led care in Ethiopia, Kenya, Malawi and Somalia

Auteur : Blomgren, Johanna

Université de soutenance : Lund University

Grade : Master’s Degree (Two Years) 2021

Résumé
Despite progress over the last decades, East Africa has one of the highest ratios of preventable maternal mortality in the world. This qualitative case study sheds light on Midwife-Led Care (MLC) in Ethiopia, Kenya, Malawi and Somalia. MLC is a model of care associated with improved health outcomes and enhanced utilization of health systems resources. Nevertheless, the model is not properly integrated into the four countries’ health systems. Three questions are answered (I) What kind of key structural barriers connected to MLC can be identified on different levels of practice ? (II) Why do these identified barriers persist ? (III) How can these identified barriers be reduced to enhance MLC ? The topic is explored through analysis of semi-structured interviews, focus group discussions, and participatory observations. The main findings demonstrate barriers for MLC connected to resource allocation, professiona l hierarchies, lack of status and respect, gender disparities in education, and few midwives involved in higher decision-making levels. Gender and societal norms, and organizational structures are some factors explaining why the barriers persist. Positive examples of collaborative practices, higher academic education, cooperation between professional associations, and role-modeling illustrate how creating change in midwives’ empowerment and thereby their ability to provide MLC may be possible.

Mots Clés  : Midwives, Midwife-led care, Women’s Health, Gender Norms, Empowerment, Kenya, Somalia, Ethiopia

Présentation

Page publiée le 1er janvier 2022