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"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 LU (2021) MIDM19 20211
Department of Human Geography
LUMID International Master programme in applied International Development and Management
Abstract
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... (More)
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, professional 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. (Less)
Please use this url to cite or link to this publication:
author
Blomgren, Johanna LU
supervisor
organization
course
MIDM19 20211
year
type
H2 - Master's Degree (Two Years)
subject
keywords
Midwives, Midwife-led care, Women's Health, Gender Norms, Empowerment, Kenya, Somalia, Ethiopia
language
English
id
9044090
date added to LUP
2021-06-21 11:24:08
date last changed
2021-06-21 11:24:08
@misc{9044090,
  abstract     = {{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, professional 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.}},
  author       = {{Blomgren, Johanna}},
  language     = {{eng}},
  note         = {{Student Paper}},
  title        = {{"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}},
  year         = {{2021}},
}