Comparison of Results Between Government Subdistrict Hospitals in Bangladesh: Without Midwives, With Midwives, and With Midwives and Mentors
| Measure | Without Midwives | With Midwives | Midwives and Mentors |
|---|---|---|---|
| Number of facilities ready for obstetric emergencies | 3 of 7 | 1 of 6 | 4 of 6 |
| Percentage of staff who valued, felt capable of using, and used evidence-based practices | 68% | 81% | 92% |
| Number of evidence-based care practices used more than 50% of the time | 4 of 8 | 6 of 8 | 8 of 8 |
| Number of evidence-based practices with significantly greater use than in facilities without midwives (fixed effect logistic regression) | N/A (reference group) | 3 of 8 | 5 of 8 |
| Midwives' competence | Staff imagined that having midwives would improve service provision. | Among nurses and managers, some affirmed midwives' contribution, while some felt they were too inexperienced to be autonomous. Midwives expressed having the capacity to do more but not being allowed (e.g., some were not allowed to deliver babies). | Managers affirmed midwives' capacities and contribution and midwives stated they were proud to be midwives. |
| Separate antenatal care corners | Nonexistent | Transitioning to staffing antenatal care corners with midwives. | Antenatal care corners consistently staffed by midwives. |
| Management of obstetric emergencies | Nurses reported that they do not manage obstetric emergencies (commonly, patients were referred). | Midwives expressed confidence in managing obstetric emergencies but having limited autonomy so were not able to if another staff person decided to refer. | Midwives said they managed obstetric emergencies. |