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Challenges to Reaching MDG5: A Qualitative Analysis of the Working Environment of Skilled Birth Attendants in Cambodia

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OBJECTIVE: To explore the working environment of skilled birth attendants (SBAs) in one region in Cambodia and the factors affecting their motivation and performance.

METHODS: A descriptive qualitative design was employed using focus group discussions with SBAs in 2 health centers and 3 referral hospitals in 1 province. Data were analyzed using a thematic approach.

FINDINGS: Five interrelated themes were identified as the main factors impacting on the SBA's working environment. These were the physical environment, remuneration and incentives, workplace culture, management practice, and professional development opportunities. The desire to supplement income also impacted on SBAs' motivation, skill development and maintenance, and technical skills.

CONCLUSION: Low wages and inadequate incentives within the context of a poorly functioning health system affected the working environment of SBAs in 1 province of Cambodia. These issues are likely to also affect the quality of maternity care. Policies that improve the working environment of staff through adequate remuneration and incentives and effective performance management systems need to be developed and implemented.


Document Type: Research Article


Publication date: September 1, 2012

More about this publication?
  • The International Journal of Childbirth is a peer-reviewed, quarterly journal publishing original research, reviews, and case studies concerned with the practice of midwifery, women's health, prenatal care, and the birth process. The journal encourages the exploration of the complex and contextual issues surrounding childbirth provision and outcomes and invites manuscripts from a wide range of clinical, theoretical, political, methodological, psychological, public health, policy, and multicultural and interdisciplinary perspectives.
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