After a thorough analysis and interpretation of the findings, the following conclusions are hereby presented: 1. That traditional midwifery, and its practitioners, are still widely patronized by rural people and are deeply entrenched in the way of life of the people of Bay2. That the hilots in Bay continue to be governed by beliefs, practices, habits and superstition, many of which are inimical to the health and welfare of the mothers and newborns3. That there are no way of telling how long it will take to supplant the hilots with better providers of midwifery care4. That the hilots with their present practices pose a serious risk, if not an actual danger to the mothers and babies5. That proper training, supervision and control of the hilots will benefit the people as well as the providers of professional health care. (Conclusions and Recommendations)
Bay, Laguna, Midwifery

Objective: This research aims to unravel the local knowledge, practices, and experiences of care during pregnancy and childbirth in one community in Batangas. Methods: Qualitative interviews with two hilots and a mother, two focus group discussions with mothers from different generations, and indigenous research methods – pakikipagkwentuhan (story-telling or informal discussions with the locals) and pagmamasid (observations of the local practices in the community) were used in this ethnographic study. The data gathered through these methods were analyzed using an interpretive approach. Results: Data showed that knowledge and practices related to pregnancy and childbirth which were viewed as rituals remain to be significant in the community because they are sources of psychological support in a highly intimate situation. These practices also help in creating a feeling of security and safety during this very uncertain period. The data also showed the different ways of making sense of risks associated with pregnancy and childbirth and this affects the decisions made by mothers, midwives and hilots during birthing. Lastly, we saw the effects of the implementation of the no home birthing policy on the hilots and the life and well-being of the pregnant women in the community. Conclusions Local practices of care during pregnancy and childbirth remain significant today because these cater to the overall well-being of women giving birth. For these women, the implementation of the no home birthing policy that changed the status of the hilots (TBAs) in the community does not address the real issues on maternal healthcare. For them, the government should have focused on continuing to address the structural and institutional problems that they have encountered in their experiences of birthing. This can be done by providing more facilities that would readily cater to the needs of birthing women and by creating a more holistic healthcare system.
Pregnancy ; Parturition ; Midwifery

Background: Healthcare workers remain the key players in the delivery of healthcare services. Their supply and distribution must be carefully monitored and taken care of. Objectives: To describe the stock of doctors, nurses, and midwives in the Philippines in 2020. Methods: This study employed a descriptive ecologic design and involves a secondary-data analysis where the relevant statistical data were retrieved from the public database in the country’s Department of Health. The data source also provides the statistics of other health professions such as medical technologists, nutritionists/dieticians, pharmacists, and dentists. However, this study limited the numerical data of the doctors, nurses, and midwives because there are readily available data for comparison. Descriptive statistics such as frequency counts, percentages, and population density were used to analyze the data. Results: The available density of health workers (14.76 per 10,000 population) composed of doctors, nurses, and midwives in the country remains at par with the recommendation of the World Health Organization (44.5 per 10,000 population). Likewise, data showed maldistribution of the health workforce still exists where a greater number of them are found in urban areas such as the National Capital Region (NCR) and CALABARZON. Majority of them are also working in the hospitals (doctors = 86.64%, nurses = 76.75%, and midwives = 48.46%) than in the primary healthcare facilities (doctors = 13.36%, nurses = 23.25%, and midwives = 51.54%). Conclusions The study revealed that maldistribution and shortage of doctors, nurses, and midwives prevail in the country. Likewise, the available workers in the country remain at par with the recommendations to meet the targets of the sustainable development goals (SDGs). The health agency and policymakers must focus on strategies to accelerate the number of health workers required in the country and redistribute them according to the areas in dire need.
Midwifery ; Nurses ; Philippines

PURPOSE: This study intends to identify the relations among labor pain and labor agentry of puerperas giving birth in midwifery clinic and perception of delivery experience, and to establish factors influencing on their perception of delivery experience. METHODS: Descriptive survey research. Data were collected from puerperas giving birth through vaginal delivery in six midwifery clinics, and they were analyzed through t-test, ANOVA, pearson's correlation coefficients, and stepwise multiple regression. RESULTS: Figures of labor pain of puerperas giving birth in midwifery clinic by stage were 4.12, 6.80 and 8.11 in average in latent, active and transitional stage, respectively, while labor agentry and perception of delivery experience showed upper-middling figures, namely 3.70 and 3.94. It was revealed that labor agentry of puerperas giving birth in midwifery clinic had negative correlation with labor pain in latent stage (r=−0.176, p=0.021). Perception of delivery experience had the same with labor pain in latent stage (r=−0.177, p=0.020) and labor pain in active stage (r=−0.159, p=0.037), whereas perception of delivery experience had positive correlation with labor agentry (r=0.750, p < 0.001). In addition, factors influencing on perception of delivery experience of puerperas giving birth in midwifery clinic were labor agentry, educational background and marital satisfaction, accounting for 58.8%. CONCLUSION: The results suggest that developing and applying nursing intervention program that increases labor agentry so that puerperas giving birth in midwifery clinic may perceive childbirth experience positively.
Female ; Labor Pain ; Midwifery ; Nursing ; Parturition ; Pregnancy

BACKGROUND & OBJECTIVE: Midwives have been the country's frontline health care providers in communities. Their role was expanded from largely providing maternal and child care services in the 1920s to provision of basic Primary Health Care services since 1970s. Despite their extensive roles, there has been no comprehensive enquiry on the professional practice of midwifery in the Philippines since it formally started in 1901. This study was conducted to (1) describe the evolution of midwifery education and regulation; (2) describe professional practice of midwifery and the midwives' role in the local health system; (3) identify gaps in the current midwifery practice, and; (4) recommend to improve and standardize the competencies of practicing midwives.

METHODOLOGY: The study is qualitative with a grounded theory approach using face-to-face Key Informant Interview (KII), Focus Group Discussion (FGD), and document review. The study, conducted from January to December 2015, purposively sought experts from different fields of midwifery, including midwifery-service providers, birthing home managers from public and private sector, academe, Department of Health (DOH), development partners, the country's three leading midwifery organizations, and the Board of Midwifery (BOM) of the Philippine Professional Regulation Commission (PRC).

RESULTS: Changes in midwifery education, scope of practice and standards were in response to the country's health challenges in maternal and child health. Public midwives were frontline implementors of 57 DOH programs. Despite their vital role and expanded workload, the tenure or plantilla positions of government midwives continued to have the same salary grade promulgated in 2000 while others, although the numbers are unknown, do not have security of tenure. There were no learning and development initiatives designed to enable midwives to become implementors of multiple programs. Regulation of midwifery practice was not cohesive. The standards of practice were program-based and were scattered in different policies.

RECOMMENDATION: The study recommends that the DOH, PRC, and midwives' organizations review and revise the scope of midwifery practice in line with global standards, as well as to implement a competency-based career development pathway that is integrated with the regulatory system.

PURPOSE: Objective of this research is to find out weaknesses of undergraduate programs in terms of personnel and financial, organizational management and facilities in view of faculty and library staff, and determining factors that may facilitate program quality-improvement. METHODS: This is a descriptive analytical survey research and from purpose aspect is an application evaluation study that undergraduate groups of selected faculties (Public Health, Nursing and Midwifery, Allied Medical Sciences and Rehabilitation) at Tehran University of Medical Sciences (TUMS) have been surveyed using context input process product model in 2014. Statistical population were consist of three subgroups including department head (n=10), faculty members (n=61), and library staff (n=10) with total population of 81 people. Data collected through three researcher-made questionnaires which were based on Likert scale. The data were then analyzed using descriptive and inferential statistics. RESULTS: Results showed desirable and relatively desirable situation for factors in context, input, process, and product fields except for factors of administration and financial; and research and educational spaces and equipment which were in undesirable situation. CONCLUSION: Based on results, researcher highlighted weaknesses in the undergraduate programs of TUMS in terms of research and educational spaces and facilities, educational curriculum, administration and financial; and recommended some steps in terms of financial, organizational management and communication with graduates in order to improve the quality of this system.
Curriculum ; Head ; Midwifery ; Nursing ; Self-Evaluation Programs ; Teaching

Parturition ; Asian Continental Ancestry Group ; Malaysia ; Pregnancy ; Midwifery

PURPOSE: The purpose of this study is to develop the optimal nursing fee for nurse-midwifery center (MC) in the national health insurance system. METHODS: The three methodologies used to calculate the conversion factors for the MCs in the national health insurance include cost accounting method, sustainable growth rate (SGR) model, and index model. In this study, the macro-economic indicators and the national statistics were used to estimate the conversion factors for the MCs. RESULTS: The optimal nursing fee for the MCs in 2011 was estimated to be an increase of 57.7% by cost accounting analysis, a decrease of 17.1% by SGR model, and a decrease of 16.1% by index model. The results from SGR model and index model could had been biased due to the upswing of medical spendings in the short-term period (2008~2009). A sensitivity analysis of pre-delivery subsidy program for OB & GYN hospitals and clinics showed that the program has substantially diminished the demand for the MC services. CONCLUSION: More reliable methodologies to estimate nursing fees precisely are required to prove the value of nurses' services and a government subsidy program for the MC services should be followed from a social perspective.
Accounting ; Bias (Epidemiology) ; Fees and Charges ; Financing, Government ; Insurance, Health ; Midwifery ; National Health Programs

Burnout, Professional ; psychology ; Humans ; Job Satisfaction ; Midwifery ; Salaries and Fringe Benefits ; Social Identification

Medical certificate, post-mortem examination or certificate guarantee their authenticity of the content through the article 233 of the criminal act. The article 233 of the criminal act states that if a medical or oriental medical doctor, dentist or midwife prepare false medical certificate, postmortem examination or certificate life or death, one shall be punished. To constitute the crime of issuance of falsified medical certificates, it is necessary for the contents of the certificate to be substantially contrary to the truth, as well as it is needed the subjective perception that the contents of the certificate are false. On the article 17 of the medical service act, no one may prepare a medical certificate, a report or certificate of postmortem examination to a patient or public prosecutor in a district public prosecutors' office, who conducts a medical service and has given the medical treatment or conducted the postmortem examination by him/herself: Provided that, such certificate or report may be issued for a patient without giving any medical treatment, if the patient has died within 48 hours after his/her last medical treatment, while if the medical doctor, dentist or oriental medical doctors who examined a patient or conducted a postmortem examination of the dead patient is unable to issue such certificate or report due to an inevitable cause or event, any other medical doctor, dentist or oriental medical doctor who works for the same medical institution, may issue such certificate or report based on the medical records of the patient.
Autopsy ; Crime ; Criminals ; Dentists ; Humans ; Liability, Legal* ; Medical Records ; Midwifery ; Physicians ; Social Responsibility*