The training and development needs of midwives in Indonesia: paper 2 of 3

A psychometrically valid training-needs instrument was administered to 332 midwives from three provinces, covering both hospital and community staff and a range of midwifery grades. The instrument had the capacity to identify occupational roles and education/training needs of the respondents.The occupational roles of the midwives varied significantly by province, indicating regional service delivery distinctions, but very little difference in the roles of hospital and community midwives. The most educated midwives attributed more importance to 35 out of the 40 tasks, suggesting an implicit role distinction in terms of level of activity. All midwives reported significant training needs for all 40 tasks. The most-educated midwives recorded training needs for 24 tasks, while the less-educated had training requirements for all tasks, which suggests that new training programmes are effective. Few differences in training needs were revealed between hospital and community midwivesThe results from this survey suggest important regional differences in how the midwife's role is discharged and underline the importance of this sort of research, in order to ensure the suitability of basic and postbasic educational provision. The study also highlights the need for further development and training of midwives in a wide range of tasks. These results provide a systematic and reliable overview of current midwifery roles and development needs and could serve to inform future training.Midwifery in Indonesia plays a particular role in improving community, maternal and neonatal health, as well as contributing towards the health targets set by the Ministry of Health. However, despite their acknowledged importance, in 2001/2002 there were still only 26 midwives per 100 000 of the population, which in absolute and relative terms represents a severe shortfall [1].One consequence of this is the high maternal and perinatal mortality rates, the former being estimated at 307 per 100 000 live bir