 Meron at that time was in charge of a remarkable number of Mizan NMWs: 59. (There were an additional 169 nurses.) Among the most highly educated of the people we interviewed, with an M.P.H. degree and Amharan ethnicity, she had served as head for three years, and eight years total. She “worked her way up,” having been a NMW in a rural community. That the Mizan Hospital supports 15 facilities means that she is in constant contact with professionals spanning a wide range of training and expertise. Many of the NMWs, as we learned through other aspects of our work, are poorly trained and lacking in certain key skills. (Our nurse midwife training program addresses this issue.) There is a high rate of turnover. During the previous year, some left due to non-payment of government wages over a six-month period. Yet Meron and many others are very dedicated. Her enthusiasm is infectious. Her ability to access key data is impressive. With extraordinarily modest salaries of no more than 5000 birr per month (~40 USD), she and others work full shifts. Extra pay is available for overloads. That the hospital now has more senior physicians and gynecologists (seven) than before is a positive. So is the fact that more pregnant women are coming via community referrals; the outreach network engages professionals who visit remote villages and homes. However, at times the numbers of women arriving has exceeded the hospital’s capacity, this causing a delay in service after arrival. Maternal health services are offered free-of-charge, but government reimbursement is often inadequate. Among the challenges Meron discussed were a lack of food at the maternal waiting area (although in-patients do receive food); she is computer literate, and noted that there is inadequate automation in some departments; the hospital does not have a blood bank, the nearest being in the town of Bonga, 120 km distant. Education programs are offered all patients; Meron perceives these as valuable. She expressed her determination to continue delivering high quality supervision and care. |
