Creating demand for Midwifery Led Care

Monday 4 February 2019


Written by, Dr. Fatema Begum, Clinical Mentor, Moulvibazar

Barolekha Upazila Health Complex (UHC) was struggling to increase institutional delivery while poor quality of services was one of the major determinants. Midwifery led care has been demonstrated in this UHC since January 2018 which created a pathway to improve quality of health services. Under this midwifery led care initiative the hospital has increased its spectrum of sexual, reproductive and adolescent health (SRAH) services; like offering comprehensive Ante Natal Care and Post Natal Care, functionalizing VIA corners, strengthen Post-Partum Family Planning services and counselling, awareness on gender based violence, adolescent friendly health services etc.

With daily monitoring and supervision, evidence based and respectful maternity care is gradually developing into a culture at the hospital. Together, SNMP’s Clinical Mentors and hospital resource persons are involved in continuous capacity development of maternal and newborn health service providers in delivering routine and emergency obstetric care. The hospital has become well equipped to stabilize the emergency cases. In this context, along with improved quality of services, the hospital authority has taken innovative steps towards increasing institutional deliveries by creating demand at the community level.

In August ’18, Dr. Ahmed Hussain, Upazila Health and Family Planning Officer (UH&FPO) has established an effective linkage among health and family planning field staff with the hospital service providers. The field staff have become oriented on Midwifery Led Care and hence can disseminate information at community level through multiple events and activities. During their Ante Natal Care, pregnant mothers also get the opportunity to visit the well organized labour rooms. The midwives/service providers provide information to the field staff about the pregnant and recently delivered mothers who in the community. Accordingly, the field staff motivate and refers the pregnant mothers at his/her catchment area for institutional delivery or mothers who are at risk.


In the monthly meetings, the UHFPO evaluates the performances of the field staff. Additionally, awarding the best performing service provider, was another initiative taken by the UH&FPO to motivate the service providers. These initiatives resulted in rapid increase in the number of hospital deliveries. In the month of October 2018, the hospital performed 108 normal vaginal deliveries and celebrated the success. As a Clinical Mentor of the Program, I have been able to witness firsthand the gradual establishment of Midwifery Led Care at Upazila Health Complexes (UHCs),  increasing awareness on Midwifery Led Care for utilization of quality maternal and newborn services.