Nora Kropp Interview

 

Sondra Jones
sondrajones@mycwi.cc
English 034W
Letters of Inquiry
5 December 2011

11-9-11

Nora Kropp (NK) Interview

Interviewer Sondra Jones (SJ)

Conducted over the phone.

SJ: What are your Credentials?

NK: Certified Practical Midwife Trained Masters of public health specializing in maternal and child heath

SK: How long have you been a midwife?

NK: 10 in the US and 6 in India

SJ: Different certifications?

NK: Just US

SJ: Where did you receive your training?
NK: Maternidad La Luz

SJ: Where is it located?

NK: El Paso Texas

SJ: How many midwifes do you have working with you?
NK: I don’t actually work as a midwife. I work on the research end but the midwifes there are some foreign some auxiliary midwives and government midwifes some Dias who are self taught low tech midwifes.

SJ: Where did the majority of them receive their training?

NK: Usually from government school nursing schools, private education coming up for midwifes in agreement with the government.

SJ: How much does it cost to become a midwife in India?

NK: That’s a good question. I don’t know but you could look it up on Google, look up Auxiliary Nurse Midwife General NM in India look for an education program

ANM one and a half to 2 GNM 3 based on quality of school

SJ: Are private a better quality?

NK: usually.

Had to stop for the night because of circumstances… plan to continue tomorrow.

11/10/11

NK: What exactly is your topic about?

SJ: Midwifery’s impact on the MDG’s

NK: Oh that’s an awesome but broad topic.

Experts from conversation….

The biggest problem in India is there are not enough skilled birth attendants.

Upper and middle class Urban India is over medicalized but poor Urban and rural areas often have no care.

National Family Health Survey shows that high maternal mortality is driven by rural India mostly in the North. There is a huge rural population and do doctor for sometimes 80 miles. And they have no transportation.

The three Delays are generally responsible for maternal Death in India.

The thee delays that need to be addressed to save motherhood are

Delay in recognizing a problem. Delay in seeking care. Delay once care is sought classically this is how it happens. In urban areas when care is sought there is a chance people will reject by the hospital because of no insurance or not enough doctors.

There are two types of facilities people can go to government and private.

SJ: Are private facilities generally better?

NK: Government are not as good as private institutes (hospitals). Doctors and nurses are over worked and under paid. Nurses do a lot of delivery. Doctors will not show up a lot of the time. Doctors that the government employs will often have privet office. So they will work in the government hospital in the morning and in the evening in their practice so that they can make more money.

The government has mainly focused on putting money into institute system.

SJ: so the government has basically said to decrease maternal mortality just put everyone in an institute.

NK: Yes but they can be full. Like we talked about in the third Delay

The main problem is hiring and keeping specialists like OB’s, anesthesiologists, surgeons, and other healthcare professionals for lifesaving measures.” They have trouble figuring out how to attract good and quality practitioners in rural areas because of Water quality, lack of reliable electricity, bugs, wild animals, lack of education opportunities for children, and lack of social companionship

NRCHM is a good resource.

OSHA workers are hired by the government to attract women and increase institute activities to get all women into institutes.

Auxiliary Nurse Midwifes did not meet WHO qualifications as skilled birth attendants. So many countries including India attempted to give more training and allow ANM’s to do more. In India sometime in the 80’s I think they conducted a study where they trained the ANM’s for 10 years but the training was not very good and the program did not decrease mortality rates. So they discounted the program and started funneling money into institutions. 

But all around the world they are finding that continual training of ANM’s is less expensive and more effective.

But ANM’s do so many things.

There is suppose to be 2 ANM’s per public health clinic but there is only one. They do many other things like polio vaccines, tuberculosis programs, education. May is not skilled in labor and delivery. Some really good ANM and make the huge differences in the community. They defiantly make an impact.

Many never take up the path of attending childbirth.

On paper all the government is doing is a good thing but in reality they can get paid and do other things other than attend births.

SJ: Wow that is so much information thank you so much for being willing to work with me and fit me into your busy schedule

NK: No problem. If you need me any further go ahead and send me an e-mail

SJ: Thank you have a safe trip back

NK: Thank you goodbye.