Village midwives in Malaysia

PIP: 292 village midwives (bidans) in Malaysia were interviewed between January 1969 and December 1970 as they came to report for training. The mean age was 47.3, 80% had had no schooling, 43% had practiced less than 10 years (32% between 10 and 20 years, 21% between 20 and 30 years, and 4% more than 30 years). On the average each bidan reported attending 3 deliveries during the past month and 26 during the past year. The average charge per delivery was about U.S.$2.00. Of 267 who responded to a question concerning other services they provided, 50% said they performed massages, 30% performed massages combined with other services, 12% said they did not do anything other than midwifery and 7% prescribed herbs and performed abortions. 67% said they first had contact with the mother during the seventh to ninth month of pregnancy, 42% between the fourth and sixth month, and 7% at or before the third month. 40% said the postpartum care lasted less than 1 week, 40% from 1-2 weeks and 19% between 2-7 weeks. Only 2 out of 198 bidans disapproved of family planning services. 99% were not worried that this would affect their job in conducting deliveries. 62% had been approached by women about family planning information services during the last 3 months. 95% thought they could help to promote the government's program by recruiting patients and distributing contraceptives. Since oral contraceptives are the most frequently used contraceptive in Malaysia, bidans could resupply the women with the pill. They could play an important role in promoting contraceptive continuation in rural areas by providing women with a continuous motivation through their constant contact. The success of using bidans in rural family planning services will greatly depend on their supervision. They can be paid with a flat salary-type payment, with an incentive scheme alone, or a combination of the two.