title: Midwives' experiences of working conditions, perceptions of professional role and attitudes towards mothers in Mozambique.
abstract: BACKGROUND
  low- and middle-income countries still have a long way to go to reach the fifth Millennium Development Goal of reducing maternal mortality. Mozambique has accomplished a reduction of maternal mortality since the 1990s, but still has among the highest in the world. A key strategy in reducing maternal mortality is to invest in midwifery.
  
  
  OBJECTIVE
  the objective was to explore midwives' perspectives of their working conditions, their professional role, and perceptions of attitudes towards mothers in a low-resource setting.
  
  
  METHODS
  midwives in urban, suburban, village and remote areas; working in central, general and rural hospitals as well as health centres and health posts were interviewed in Maputo City, Maputo Province and Gaza Province in Mozambique.
  
  
  METHODS
  the study had a qualitative research design. Nine semi-structured interviews and one follow-up interview were conducted and analysed with qualitative content analysis.
  
  
  RESULTS
  two main themes were found; commitment/devotion and lack of resources. All informants described empathic care-giving, with deep engagement with the mothers and highly valued working in teams. Lack of resources prevented the midwives from providing care and created frustration and feelings of insufficiency.
  
  
  CONCLUSIONS
  the midwives perceptions were that they tried to provide empathic, responsive care on their own within a weak health system which created many difficulties. The great potential the midwives possess of providing quality care must be valued and nurtured for their competency to be used more effectively.
authors.affiliation: Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden. Electronic address: katja.adolphson@gmail.com.
authors.forename: Katja
authors.initials: K
authors.lastname: Adolphson
authors.affiliation: Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden. Electronic address: pia.axemo@kbh.uu.se.
authors.forename: Pia
authors.initials: P
authors.lastname: Axemo
authors.affiliation: Department of Women's and Children's Health, Uppsala University, SE-751 85 Uppsala, Sweden. Electronic address: ulf.hogberg@kbh.uu.se.
authors.forename: Ulf
authors.initials: U
authors.lastname: Högberg
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000379:methods / Q000592:standards; D003906:Developing Countries / Q000191:economics; D005260:Female; D006295:Health Resources / Q000600:supply & distribution; D006801:Humans; D009073:Mozambique; D009721:Nurse Midwives / Q000523:psychology*; D010465:Perception; D011247:Pregnancy; D024382:Professional Role / Q000523:psychology; D036301:Qualitative Research; D017132:Workplace / Q000592:standards*
keywords: Developing countries; Empathy; Maternal mortality; Midwifery; Mozambique; Professional role