PURPOSE:
Since its inception in 2012, the Midwifery Education Programme (MEP) at BRAC University has graduated over 1,300 midwives to advance maternal health in Bangladesh. Despite this progress, it remains unclear whether graduates are able to fully apply their midwifery competencies in practice. This study explores how BRACU-trained midwives engage their professional skills, deliver respectful maternity care, and navigate challenges in diverse work settings.

DISCUSSION:
A mixed-methods approach was employed to capture the insights into midwives’ experiences across government and private facilities. The study explored the divergence between professional training and actual roles, the constraints imposed by workplace norms, and midwives’ aspirations to contribute more effectively to maternal care.

EVIDENCE WHERE RELEVANT:
Data were collected through surveys (n=256), focus group discussions, and key informant interviews with midwives, health administrators and supervisors. Among respondents, 39.5% were employed in government and 60.5% in private settings. Although 89.5% held the title “midwife,” 7.80% held the title as nurse. In GOB settings 35 % were involved in nursing duties.In private sector 64% reported providing nursing care and performed administrative work. Alarmingly, some were assigned to unrelated roles such as vaccination, laboratory work, and surgical assistance. Structural barriers—such as the absence of designated midwifery posts in private sector—undermined their capacity to practice evidence-based midwifery. Notably, 87% midwives expressed interest in establishing independent delivery centers but identified critical needs for professional association support, administrative facilitation, and financial assistance.

KEY MESSAGE:
While midwives are highly motivated and equipped to deliver respectful maternity care, systemic constraints limit their ability to practice their core skills. Policy decision to finalize carrier path in midwifery, strict monitoring to adhere midwifery SOP in private sector, strengthen professional recognition, and promote community awareness are essential to unlock the full potential of midwives in improving maternal and neonatal outcomes in Bangladesh. Workforce - sustainability 2 (including three-minute presentation competition)