Please note - this is a temporary window. id21 is joining forces with Eldis and therefore the id21 website has been suspended. Soon all id21 content will be available on the Eldis website.

Learning to listen: training nurse midwives in India

What training should auxiliary nurse midwives, who are the first point of entry in primary care services in India, receive? What are the implications of providing sexual and reproductive healthcare rather than just providing family planning services for the training of these staff? The Brihanmumbai Municipal Corporation, together with the Society for Health Alternatives in India and the Royal Tropical Institute, Amsterdam, looked at how involvement in a project on pelvic inflammatory diseases in the slums of Bombay affected midwives’ skills and attitudes to their work and their clients. Following the project's completion the midwives were better able to communicate with and listen to the needs of their patients.

India was the first country in the world to introduce nationwide family planning in the 1950s. But in 1975 midwives were given targets to meet for contraceptive use and sterilisation. It was disastrous for community relations. In the 1990s a more woman-centred approach emerged in international medicine which put women’s needs and problems centre stage. The Indian midwives were no longer expected to meet contraceptive targets irrespective of the needs of their patients but to give women the support to make their own decisions. Yet there has been little opportunity for them to explore their own views and attitudes which have been formed as young women growing up in a male-dominated society.

Midwives are at the bottom of the Indian medical hierarchy and come from a similar background to the women they work with. Because of this they are in an ideal situation to empathise with their patients. Training for the project involved 40 meetings as well as 13 workshops over several days. The midwives helped to design questionnaires, collect information, and analyse results. They found it difficult to bring out the views of the patients and lead group discussions because they were used to giving advice rather than exploring people’s needs and attitudes. Despite these drawbacks the research results were useful.

The study found the midwives:

had learnt how to talk and listen to their patients
were able to talk about sexual practices with their patients
were less judgmental of an unmarried pregnant girl or a widow who had sexual relations
had increased in self-confidence; their new skills had affected their own relationships at home in a positive way
had better relationships with their colleagues and superiors, and had learnt about team work and how groups can function effectively.

The report recommends that midwives’ basic training should include:

the concept of gender and sexuality
social, cultural and political factors affecting women’s health
communication and counselling skills
training in handling group situations
on-the-job training and ongoing support for existing midwives.

The study found that the opportunity to be involved in a research project helped the midwives to better understand the problems, needs and strengths of the groups with whom they work.

Source(s):
‘The role of research in sensitizing auxiliary nurse midwives to a women-centred approach to healthcare in Mumbai, India’, in ‘Realising rights: transforming approaches to sexual and reproductive well-being’, A. Cornwall and A. Welbourn, by R. Khanna et al, 2002 Full document.

Funded by: Sida; Swiss Agency for Development and Co-operation (SDC); UK Department for International Development

id21 Research Highlight: 28 August 2003

Further Information:
Korrie de Koning
Royal Tropical Institute (KIT)
Postbus 95001
1090 HA Amsterdam
Netherlands

Tel: +31 20 5688561
Fax: +31 20 5688444
Contact the contributor: k.d.koning@kit.nl

Brihanmumbai Municipal Corporation, India

Royal Tropical Institute, Amsterdam

Views expressed on these pages are not necessarily those of DfID, IDS, id21 or other contributing institutions. Articles featured on the id21 site may be copied or quoted without restriction provided id21 and originating author(s) and institution(s) are acknowledged. Copyright © 2009 IDS. All rights reserved.

id21 is funded by the UK Department for International Development. id21 is one of a family of knowledge services at the Institute of Development Studies at the University of Sussex. id21 is a www.oneworld.net partner and an affiliate of www.mediachannel.org. IDS is a charitable company, No. 877338.