Task analysis of Midwives (Part 2)

This paper is presented in recognition of work contributed by midwives, the category of health worker who exists as the front-line worker at the periphery of the health care delivery system. It attempts to describe the current situation of midwives in thecontext of their socio-demographic, economic and task profiles. The study subjects were midwives currently employed by the Ministry of Health. Different research methods were used, notably the mailed questionnaire survey for all midwives, the Shadow Observation method for midwives stationed in one township in Yangon Division and the Self-Dntry Diary for midwives of one township representing each of the fourteen States and Divisions.s For additional in-depth information pertaining to their training needs, work conditions, job satisfaction, career ladder and continuing education requirements, a Focus Group Discussion was conducted at the Institute of Nursing (ION). The study subjects for this discussion comprised of midwives from all States and Divisions attending a Lady Health Visitor (LHV) course. The research instruments for each method was devised based upon an existing list of job descriptions of midwives that had been established by the Department of Health. All methods yield a fairly consistent priority listing of tasks performed. Albeit the vast array of additional tasks imposed upon them by the global and local changing health paradigms, Maternal and Child Health remains the dominant function of midwives across rural and urban as well as geographical regions. The benefit that can be derived from this finding is the possibility of skill improvement in this area of service which could be conducive towards the enhancement of the quality of life of mothers and children.

Highly selective vagotomy in the treatment of chronic duodenal ulcer

A presentation of nineteen cases of D.U. treated by HSV is made. Its advantages and long term sequelae are discussed. The initial safety record of this procedure has continued unblemished and it remains the safest operation in treating duodenal ulcer disease. With proper selection of cases, approximately 10-15 per cent of our D.U. cases are treatable by this method.

Adenomyomatous polyp of left hepatic duct

A case report of adenomyomatous polyp originating from the left hepatic duct causing surgical jaundice is made. Adenomyomatous polyp originating from the left hepatic duct is histologically similar to adenomyomatous hyperplasiaof the gall bladder as shown in the references above. In various journals available here, this type of polyp with its origin from hepatic duct has not been mentioned. Another important point is that it can be mistaken radiologically & clinically as cholangio carcinoma causing obstructive jaundice.

Management of liver injuries

A series of (22) patients admitted with liver injuries is presented. Although (4) deaths were recorded only (3) were hepatic related, thus giving mortality rate of (14 per cent). Common clinical features were presented and management problems were discussed with a view to lowering the morbidity and mortality.