Assignment Name: Study on Pathways to Women’s Empowerment Through Midwifery Education

Country: Bangladesh

Client Name: Foreign, Commonwealth and Development Office (FCDO), formerly DFID

The “Pathways to Women’s Empowerment through Midwifery Education” study was commissioned by the Foreign, Commonwealth and Development Office (FCDO) to explore how midwifery education contributes to the empowerment of women, particularly focusing on midwives in Bangladesh. The study was part of the broader Better Health in Bangladesh (BHB) programme and its Strengthening Midwifery in Bangladesh (SMiB) initiative. The core objective of the study was to determine the extent to which the midwifery education programme has contributed to social empowerment, confidence building, and economic independence of midwives at individual, family, and community levels.

Bangladesh has made significant progress in developing a cadre of professional midwives through the SMiB programme. However, the impacts of this education on gender equality, social mobility, and economic empowerment had not been formally studied. This study sought to fill this gap by assessing how the educational programme shapes midwives’ professional and personal lives, including their ability to make decisions, their acceptance in communities, and the extent to which they influence family and community dynamics.

The study also aimed to assess the role of midwifery education in improving maternal health outcomes, empowering young women from socio-economically disadvantaged backgrounds, and fostering a professional identity for midwives in Bangladesh. The study utilized the Ipsos 2019 Women Empowerment Framework, which focuses on individual, household, and community empowerment dimensions.

The overall objective is to determine if the midwifery education programme contributed towards empowering the midwives and if so, how and in which ways.

Specific guiding questions for the study should include:

• What are the aspects of professional empowerment in midwifery profession? To what extent the trained midwives feel empowered to demonstrate their leadership skills at work? Compare their perception of empowerment before and after the training.
• To what extent they were able to effectively motivate and mobilise self and others to accomplish positive outcomes in midwifery practice and work environment?
• To what extent these girls were able to emphasise the importance or influence the mind-set of continuing education for women in their community or family?
• In project locations, is there any change with regards to acceptability of a midwife in the community?
• To what extent families of midwifery students realises the importance of this profession and demonstrated their support for the trained midwives to continue their profession?
• To what extent financial contribution of trained midwives improved their status in their respective families and allowed them to influence any of their household decision makings?
• To what extent the trained midwifery students and faculty demonstrated their improved institutional performance and maternal and new-born health related competencies?
• To what extent the programme has improved the status of women in the society and lives of the midwife students and whether there has been any significant change to the attitudes of the midwives?

DM WATCH team conducted the following activities:

Planning and Consultation:

• Initial discussions with FCDO to understand the study’s scope, objectives, and methodology.
• Reviewed secondary data such as previous assessments, policies, and reports related to midwifery education and women’s empowerment in Bangladesh.
• Finalized the study design, ensuring alignment with gender empowerment frameworks and evaluation methodologies for midwifery education.

Data Collection and Fieldwork:

• Developed detailed data collection tools, including interview guides for In-depth Interviews (IDIs), Focus Group Discussions (FGDs), and Key Informant Interviews (KIIs).
• Conducted 12 IDIs with current midwifery students (both first-year and final-year) and licensed midwives to explore their personal empowerment, confidence levels, and professional growth post-training.
• Facilitated 2 FGDs: one with parents and families of midwives in Sylhet and the other with service recipients and community members in Dhaka to understand the community’s perception of midwifery.
• Conducted 9 KIIs with representatives from government bodies, midwifery education institutions, FCDO, UNFPA, and other relevant stakeholders to gather institutional perspectives on midwifery education’s impact.

Social and Communication Skills Assessment:

• Assessed the impact of midwifery education on social skills and communication abilities of the midwives, especially in engaging with families and communities.
• Analyzed how midwives’ education influenced their ability to deal with patients, manage crises, and effectively communicate in both clinical settings and community health environments.

Data Management and Analysis:

• Employed qualitative analysis techniques to process data from IDIs, KIIs, and FGDs, including thematic coding to identify key themes around empowerment, confidence, and leadership.
• Cross-referenced findings to develop a comprehensive analysis of how midwifery education influences decision-making, economic independence, and social acceptance.

Reporting and Recommendations:

• Developed a final evaluation report that included findings, key insights, and recommendations for enhancing midwifery education’s contribution to gender equality and women’s empowerment.
• The report highlighted the positive impacts of midwifery education on midwives’ confidence, professionalism, and leadership, while also recommending strategies for scaling up midwifery education and integrating entrepreneurial opportunities for midwives.
• Provided policy recommendations to FCDO, government agencies, and NGOs involved in midwifery education to enhance midwives’ professional roles and improve their influence within communities.

Dissemination and Stakeholder Engagement:

• Organized a national dissemination seminar on midwifery education and women’s empowerment, held on 1 June 2022 in Dhaka. The seminar was attended by over 150 stakeholders, including government representatives, midwifery institutions, development partners, and midwifery students.
• Presented the findings of the study to key stakeholders, including FCDO, UNFPA, and Bangladesh Midwifery Society (BMS), fostering discussions on improving midwifery policies, expanding community-based midwifery care, and addressing job security and private sector engagement.
• The dissemination event provided a platform for knowledge sharing, feedback collection, and next steps planning for further improving the midwifery profession and its impact on women’s empowerment.

This study provided important insights into how midwifery education in Bangladesh is contributing to empowering women both in their professional lives and in their personal roles within the family and community. The recommendations will help shape future policies and programs aimed at strengthening the midwifery sector and promoting gender equality in Bangladesh.