News
Midwife shortage increases to 3,000, raising maternal health risks
View(s):By Nathara Abeywickrema
The Government Midwifery Service Association (GMSA) has expressed concern about shortages of maternity staff, with some 3,000 vacancies islandwide.
GMSA president Devika Kodithuwakku told the Sunday Times that the public sector midwife shortage had affected maternal care in a negative manner and was taking a heavy toll on the families they cared for.
Midwives are important members of the healthcare system and contribute to ensuring that quality maternity services are extended to patients.
“On average, 12% of government employees retire annually. Midwives are not recruited annually. There is a severe shortage due to non-recruitment. The impact of the shortage of midwives was reported to be directly related to poor provision of quality care as a result of increased workload,” Ms. Kodithuwakku explained.
Basically, in line with the guidelines of the Family Health Bureau (FHB), one midwife should serve 1,500–2,500 women. That said, it has gone a step further in addressing the shortage of about 3,000 midwives.
“When taking into account Colombo alone, mothers confront difficulties in polyclinics in view of the fact that only two to three midwives are most likely to be at service. This situation has led to midwives feeling drained and struggling to cope with an overwhelming workload,” she added.
Unusual working patterns of midwives affect the delivery of service and contribute towards their leaving the profession, while the ever-increasing dedication in the face of the rising shortage means crisis management measures are needed, Ms. Kodithuwakku said.
The GMSA chief also lamented the absence of a vision for the betterment of the service. She said the association was of the view that staffing deficits further promoted poor clinical outcomes and could affect the midwives’ health and morale.
She said the situation called for an adaptive measure similar to a staffing level model that would regularly evaluate staffing needs.
“Lack of continuous care from the midwives points to complications in intervention, namely forceps and Caesarean deliveries. Maternal and child health will be directly impacted, and there could be an increase in maternal mortality rates in the country on the grounds of current midwife shortages,” Mrs. Kodithuwakku said.
In addition, the GMSA underlined that most of the midwifery units reported growing difficulty in filling vacancies and stressed that their units were not adequately funded. At present, vacancy rates are the worst in the country; not even one in 1,000 openings has been filled in the past year.
Dr. Chithramalee de Silva, Director of the Family Health Bureau (FHB), which comes under the purview of the Ministry of Health, said: “Midwifery is the backbone of women’s and children’s healthcare, plus an important component of a system for curtailing maternal and infant mortality. The present conditions highlight the necessity for regular recruitment, adequate funding, and expanding the midwifery cadre.
“It is expected that the current batch will pass out by the middle of next year after placement and training. Recruitment is in order this December if the Cabinet gives the go-ahead.’’
Taking note of the challenging circumstances in the Western Province itself, an official of the GMSA pointed out that there had been an equal shortage in the training of administrative health service personnel for nearly a year.
She said the system of midwives being given grade-relevant promotions and being remunerated according to their merits and experience has come to a halt. Moreover, the government’s provision of mobile phone allowance, travel allowance, and stationery has also reached a standstill for over two years.
Besides, midwives who come from outstations face more difficulties in their work areas due to their inability to provide themselves with residential settings. The official said the Rs. 750 a month allowance given to midwives to set up office facilities in their work areas was woefully inadequate.
Due to some issues at the ministry, student midwives who passed interviews in 2015 were given placements only after four years. At present, 1,200 eligible candidates await recruitment. Mostly, the respective student midwives are placed to pass one academic year and undergo continuous clinical training of six months from nursing institutions, she added.
Hence, midwives on the front lines call for a quick fix to their problems, including the filling of the vacancies, so that they can deliver midwifery of the highest standards to prevent the collapse of the healthcare system.
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