Topic : Problems in Midwifery Education in Indonesia

Question : Analyse the problems of midwifery education in Indonesia

Introduction :Amidwife has an important role related to reducing maternal mortality

rates in Indonesia. Indonesia has several problems in midwifery
education systems which need to be amended to enhance the quality of
midwife graduates.
Education system, transition shock, quality of midwife
Definition : Midwifery education is a program which trains the students to be
eligible as a registered midwife.

Thesis statement : Three main problems of midwifery education are a gap between the
supply and demand of graduates and workplaces, the lack of experience
of new graduate students and limited participation in the clinical field by
lecturers.

Outlines :
1. There is a gap between gap between the supply and demand of graduates and
workplace planning
- Many midwifery institutions were established to fulfil the need of midwives several
years ago.
- The total of population in Indonesia is around 250 million and the total number of
midwives in Indonesia is more than 250.000 midwives.
- The fact shows that more than 70% primary health centres have a surplus of
midwives which include in rural areas. However, remote areas have the lack of
provision of midwives.

2. Newly graduate students might have lack of clinical experience

- Many midwifery institutions were established to fulfil the need of midwives several
years ago.
- The ratio of woman giving birth and midwifery students is not balanced in several
places particularly in a city with many midwifery schools. Hence, students have high
competition to get their clinical experiences and report targets for midwifery care.
 - Midwifery students sometimes only observe the patients and put it into their reports
due to many students taking clinical placements.

3. There is limited participation in the clinical field by lecturers

- Lecturers often have lack of opportunities to maintain their clinical skills due to their
working hours on campus.
- Recruitment for new lecturers for some institutions does not require clinical
experience.
- Lecturers only supervise their students in the clinical field and check their progress
reports for midwifery care. In addition, lecturers examine clinical skills and
competences of the students and evaluate them based on the theory concept.

References :

Albarran, JW &Rosser, EA 2014,‘The challenges facing midwifery educators in sustaining a

future education workforce’,Journal ofMidwifery,vol. 30,no. 8, pp. 949-955, viewed 5 February
2015(online Scopus)

Gillespie, M &McFetridge, B 2006,‘Nurse education – the role of the nurse teacher’,Journal of

Clinical Nursing,vol. 15,no. 5, pp. 639-644, viewed 5 February 2015 (online Scopus)

Sharif, F&Masoumi, S 2005, ‘A qualitative study of nursing student experiences of clinical

practice’, Journal of BMC nursing,vol. 4,no. 1, viewed 5 February 2015 (online Scopus)

The World Bank 2015, World Development Indicators : Health systems, viewed 5 February
2015, http://data.worldbank.org/indicator/SH.MED.NUMW.P3

Feri Anita Wijayanti

Group 5
Somebody has to shut these
schools down,” argues Anne Hyre,
director of a United States government-
funded program developed by the
Johns Hopkins Program for Interna-
tional Education in Gynecology and
Obstetrics (Jhpiego) to bolster training
in 150 hospitals and 300 community
health centres so as to reduce maternal
mortality rates. “There are now roughly
750 academies churning out 40 000
graduates a year. And many of these
graduates have never touched a body.
These students are being misled.”

Although Pakistan produces a surplus of medical doctors,

the maternal and neonatal morbidity and mortality health
statistics remain high (Lazhari, 2006 in Rukanuddin, 2007).

Indonesia is one of the few countries that have imple-

mented initiatives to provide midwifery care in the commu-
nity. In 1989, the Indonesian Government launched a safe
motherhood programme that aimed to assign a midwife to
every village.9
Within seven years, more than 54 000 midwives had been posted,10
and the proportion of births managed by
a midwife or other health professional had nearly doubled
(from 35% in the late 1980s to 69% in 2000) Ronsmans,2008