The purpose of this paper is to provide a historical overview of midwifery education in Jordan during the past fifty years with an emphasis on the first bachelor of midwifery program in Jordan. Nine challenges of midwifery education that include expanding midwifery educational needs, accreditation of programs, recruiting qualified faculty members, clinical training, midwifery preceptorship, exit examinations, continuing midwifery education, recognition of midwifery graduates, and lack of graduate midwifery programs are presented. Proposed solutions for these challenges are discussed.
Keywords: education, Jordan, midwifery
Jordan, as a developing country in southwest Asia, has a population of 5.5 million, a birth rate of 21.7/1000, a fertility rate of 2.7, a population growth of 2.6%, a maternal mortality rate of 41/1000, and an infant mortality rate of 17.4/1000 (Department of Statistics, 2005). These indicators are relatively high compared to most developed/industrial countries such as the United States were the population is 298.4 million, the birth rate is 14.1 /1000, the fertility rate is 2.1, the population growth rate is 0.9%, the maternal mortality rate is 8.3/1000, and the infant mortality rate is 6.4/1000 (World Factbook, 2006). Throughout the past twenty years, the Jordanian health indicators have dramatically improved despite enormous challenges to the health care system.
The Jordanian health care system consists of public health care services led by the Ministry of Health, military health care services, and private health care services. The Jordanian Ministry of Health employs 3250 physicians, 2543 registered nurses and 963 midwives who attend to over 71000 annual deliveries that occur in public health care clinical settings (Department of Statistics, 2005). These health care professionals provide the majority of health care services to the Jordanian public. Unfortunately, shortages in qualified nursing and midwifery personnel remain key obstacles that face the Jordanian health care system.
Another important challenge to health care in Jordan is the increasing numbers of women of childbearing age coinciding with the constant shortage of qualified midwifery staff that can attend to the health care needs of this particular population group. The issue of midwifery shortage and other midwifery issues such as professionalization and regulation are not particular to Jordan; they are international problems (McKendry & Langford, 2001; Fullerton, Severino, Brogan & Thompson, 2003; Neglia, 2003). Many countries such as The United States, Canada and The United Kingdom have had to deal with the issues of midwifery professionalization, regulation, and shortage in their own way, with some countries experiencing more success than others. In many countries in the world such as the UK, Canada, and Peru, and as a result of strong academic midwifery programs, more professional midwives have joined the health care workforce in their respective countries each year. Furthermore, midwives in these countries have gained full professional status and function as independent health care providers as a result of better education and professionalization (Barton, 1998; McKendry & Langford, 2002; Neglia, 2002). Hence, an effective strategy among several countries in the world to overcome staff shortages and other professional issues in health care professions has been improving basic and advanced education for all health care professionals (WHO 2001; Munich Declaration, 2002; McKendry & Langford, 2002; WHO, 2002).
In Jordan, shortcomings related to adequate legislation, organizations, and professionalization of most of the health care professions, specifically for nursing and midwifery, still exist. The issues of legislation, organization and professionalization of health care professions remain pertinent today as they were more than 30 years ago in Jordan, despite the fact that there are two professional bodies that are currently working to deal with these important issues. …