SWOT analysis of Community Midwifery Program in Pakistan

The community midwifery program was launched in 2006 by the Government of Pakistan as a major initiative to provide skill birth attendance to women living in rural areas of Pakistan. The main purpose of the program is to extend maternal and newborn services to the communities, through the selection and training of community midwives (CMWs) from rural areas, and to deliver services to their local communities. However, there is a substantial difference between the number of CMWs trained and those working at their birthing stations. Therefore, this paper uses a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis to evaluate the different aspects of the CMW program. To avoid potential bias in the analysis and results, all four investigators reviewed the content and the published literature. The results from the evaluation of the reviewed literature provided findings on the strengths, weaknesses, opportunities, and threats of the CMW program. Strengths of the Community Midwifery program include enrollment criterion of community midwives, extensive coverage of midwifery services, management and supervision of the program, healthcare delivery, and positive effect of the program on health indicators. Weaknesses include weak management of the program at district levels, problems in funding, job insecurities of community midwives, weak supplies and equipment provided to midwives, weak referral systems, poor quality care, and progress in meeting targets. Opportunities include the community’s acceptability, health system research, and support for the referral system. Threats include financial affordability, social and cultural norms, funding problems, political and socio-cultural environment, and non-acceptance by established medical professions. The strengthening of the Community Midwifery program requires more political commitment and proper integration into the existing health system of Pakistan.