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@#Midwives are primarily considered as professionals with expertise in assisting women before, during, and after childbirth. Thus, the competencies for midwifery as defined by the International Confederation of Midwives revolve principally around assessment and provision of care to women and the fetus/newborn/infant during the pre-pregnancy and antenatal periods, labor and birth, postnatal/postpartum periods.1 The availability of skilled midwives in communities has allowed women, especially those who belong to lower income groups, to access professional services around childbirth, as reflected in responses from the National Demographic and Household Survey.2 For instance, while 50% of all women surveyed received antenatal care from a midwife, it is notable that 70% of those who belonged to the lowest wealth quintile were seen by a midwife during the antenatal period. Furthermore, midwives assisted 30% of deliveries reported by respondents, while roughly a little over a third of deliveries for each of the three lowest quintiles were attended by a midwife. Furthermore, in the Philippine setting, midwives are recognized as the first professional point of contact for most members of a community, especially in rural and remote places, as midwives are the ones deployed to manage Barangay Health Stations. Elaborating the scope of the practice of midwifery in relation to the provision of “primary health care services in the community” as stipulated in Republic Act No. 73923, the Board of Midwifery of the Professional Regulation Commission, in a primer for the profession, stated that midwives are expected to, among others, (a) implement government health programs in accordance with policies and guidelines of the Department of Health; (b) supervise barangay health workers; and (c) manage a Barangay Health Station.4 Stated differently, midwives, given the scope of work that they do and the areas where they are deployed, serve as the face and touchpoint of the health sector in our communities. They are the embodiment of the different health policies and programs enacted at the national and local levels through which Filipinos experience, individually and collectively, the drive for better health (or lack thereof ) advanced by different agencies, personalities, and stakeholders. However, as pointed out by Felipe-Dimog et al.5 in this issue of Acta Medica Philippina, midwives, especially those working in the public health sector, may take on roles beyond that contemplated by law. For instance, in the course of my professional practice during which I was deployed briefly in a rural health unit, and worked with an urban health department, I have encountered midwives who were tasked to work as program coordinators (or assistant coordinators), sanitation inspectors, field epidemiologists, and supply managers, among others, because of scarcity in the overall staff complement of health departments. Given their close ties with their areas of assignments, midwives are also expected to be community coordinators, if not organizers. The extent to which midwives are assigned these additional tasks depend on their professional relationship with their immediate supervisor; the level of trust and confidence reposed on them by their superiors; in some instances, their attendance to specific training workshops; as well as the availability of more qualified personnel (or lack thereof ) in the locality. Yet despite all these – placement in remote, if not hardship posts; additional assignments beyond their job description – midwives receive salaries that may not be commensurate after consideration of the job context. Staff midwife positions (i.e., Midwife I to III) in government institutions are remunerated at Salary Grades 9 to 13 (i.e., approximate gross pay of PHP 21,000 to PHP 31,000, based on the fourth tranche of the Salary Standardization Law, but may be lower depending on the income classification of the local government unit6). Additional compensation and benefits under special laws may not always be provided as this will depend on the paying capacity of the employing agency. Furthermore, midwives – especially those who completed the two-year program under the previous policy – also must contend with issues concerning their professional status. I have personally encountered community members who do not consider midwives as professionals in the same league as nurses or physicians, or who view midwives as “assistants” or “subordinates” of nurses and physicians, forgetting that a certain degree of independent practice is allowed each professional licensed by the Republic of the Philippines. Midwives play a crucial role in caring for Filipinos not only around childbirth – this is their primary professional duty – but throughout the lifespan – especially for midwives working in local health departments. Stakeholders must not forget to give due recognition to the value and worth contributed by midwives in shaping the health and well-being of each generation of Filipinos.
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TocologiaRESUMO
Objective Applications and grants of young scientists fund on Health Sciences of National Natural Science Fund in Shanghai First People's Hospital,Shanghai Jiao Tong University during 2011-2015 were analyzed with an attempt to explore the ways to increase the funding rate.Methods x2 test and t test were performed,and a binary Logistic stepwise regression model was established to determine variables influencing the results of applications.Results During 2011-2015,504 applications were presented among which 119 were granted.The funding rate was higher than the average value of the Department of Health Sciences.The results of Logistic regression analysis indicated that degree and the highest impact factor of SCI articles published by applicants were the key determinants predicting whether an application will be granted or not.When applicants applied young scientists fund in one or two years after their postgraduate study,the funding rates were 35.51％ and 28.13％ respectively,which were both higher than the corresponding annual funding rates.It declined thereafter and became lower than the corresponding annual funding rates.Conclusions SCI article is an important aspect of academic achievements of applicants,which is a prerequisite for an application to be granted.However,a scientific and innovative project may be critical for the outcome of an application.The results of the current research suggest investigators apply young scientists fund as early as possible.
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Objective Data on applications and grants of general program on health science of National Natural Science Fund from Shanghai First People's Hospital,Shanghai Jiao Tong University (SFPH) during 2011-2014 were analyzed with an attempt to explore the ways to promote the funding rate.Methods x2 test and t test were performed,and a binary Logistic regression model was established to determine variables influencing the results of applications.Results There were 367 applications in SFPH during 2011-2014,86 of which were granted.The funding rate was higher than that of Department of Health Science.The total and highest impact factor of SCI articles published by applicants of granted programs were both higher than those of non-granted programs.The significance of these two factors in predicting whether an application will be granted was confirmed by the results of Logistic regression analysis.Conclusions SCI article is an important aspect of academic achievements of applicants,which is a prerequisite for an application to be granted.However,a scientific and innovative project may be critical for the outcome of an application.
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In the past, education of acupuncture/ moxibustion in Taiwan depended on the masters-disciples relation. The knowledge of acupuncture/ moxibustion was transmitted to disciples individually.<BR>Since its establishment in 1955, The Taipei Society Acupuncture and Moxibustion improved educational pro- gram to more systematic one. In the following 20 years varieties of studies in this field were conducted, people also turned their eyes to these traditional remedies<BR>Though acupuncture and moxibustion had begun to be accepted by people, the new medical law was en- forced in 1975, which disqualified the acupuncturists for medcial practice. As a result, many of the acupuncturists and moxibustionists left Taiwan for overseas. Unlike many other nations, Taiwan has no system for certification of acupuncturists/ moxibustionists. The traditional Chinese doctor in Taiwan, after passing the examination for Chinese Medicinal exam can practice the Chinese herbal medicine and the acupuncture/ moxibustion. It seems an inconceivable system.<BR>It is only after 1989 that the subjects on acupuncture/ moxibustion medicine were included in the exams for the traditional Chinese doctor in Taiwan. But it still doesn't include tests of practical skills. This is more of a hindrance than a contribution to acupuncture and moxibustion in Taiwan.<BR>Though there has been the legalization movement for acupuncturists/ moxibustionists during the past 30 years, it met opposition from both of the health bureau and the traditional Chinese doctor trade union. The license system for acupunturist is still left uncertain.<BR>Now in Japan, the high tech device like electronic microscope, micro inductor and micro-electric are introduced in the studies of acupuncture/ moxibustion medicine. And in the field of scientific research of the acupuncture and moxibustion, Japanese seem to have more grant view than other country. The health government of Taiwan should turn their eyes to the reality and change its policies towards this effective medicine.<BR>Now acupuncture and moxibustion medicine has become one of the international research topics. In recent years WFAS academic congresses are held every year in the different nations. Here I would like to suggest that in advanced country like Japan, a new university specializing in acupuncture/moxibustion medicine should be established and it should accept and educate foreign student from overseas with international curriculum. Only the continuous and faithful exchange of the young scholars would recover the true friendship between Taiwan and Japan.