Identifying clinical and educational difficulties of midwives in an Indonesian government hospital maternity ward: Towards improving childbirth care

Abstract

Objective: This pilot study aimed to describe the difficulties and educational needs of Indonesian midwives working in a government hospital and thereby propose possible solutions towards improving the quality of childbirth care.

Methods: This study had a qualitative exploratory design. Focus group discussions were conducted with 22 Indonesian midwives working in a government hospital. Data were analyzed using content analysis.

Results: These Indonesian midwives felt they faced difficulties in providing quality care such as “shortage of resources to provide health services”, “lack of resources for professional continuing education”, “insufficient evidence-based practice”, “difficulty in providing care due to cultural background”, and “challenges teaching students”. Therefore, these difficulties contributed to their uncertainty about the quality of the care they could provide. They desired continuing education to update their knowledge and skills and fill the gap between theory and actual practice. They wanted more in-depth information about “pregnancy”, “delivery”, “puerperium”, “neonates”, and “emergencies”. These topics reflected the wide range of care needed by the diverse group of Indonesian women who visited government hospital.

Conclusions: Indonesian midwives working in a government hospital had difficulties in providing quality care for women with different needs and backgrounds due to the shortage of midwives, and lack of hospital beds and lack of essential equipment. Even though midwives wanted to learn or update their knowledge and skills to fill the gap between theory they learned in school and the demands of actual practice, the opportunity to have training was very limited.