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Objectives: Educated and skilled midwives are required to improve maternal and newborn health and reduce stillbirths. There are three main approaches to the pre-service education of midwives: direct entry, post-nursing and integrated programmes combining nursing and midwifery. Within these, there can be multiple programmes of differing lengths and qualifications, with many countries offering numerous pathways. This study explores the history, rationale, benefits and disadvantages of multiple pre-service midwifery education in Malawi and Cambodia. The objectives are to investigate the differences in education, roles and deployment as well as how key informants perceive that the various pathways influence workforce, health care, and wider health systems outcomes in each country.Design: Qualitative data were collected during semi-structured interviews and analysed using a pre-developed conceptual framework for understanding the development and outcomes of midwifery education programmes. The framework was created before data collection.Setting: The setting is one Asian and one African country: Cambodia and Malawi.Participants: Twenty-one key informants with knowledge of maternal health care at the national level from different Government and non-governmental backgrounds.Results: Approaches to midwifery education have historical origins. Different pathways have developed iteratively and are influenced by a need to fill vacancies, raise standards and professionalise midwifery. Cambodia has mostly focused on direct-entry midwifery while Malawi has a strong emphasis on dual-qualified nurse-midwives. Informants reported that associate midwifery cadres were often trained in a more limited set of competencies, but in reality were often required to carry out similar roles to professional midwives, often without supervision. While some respondents welcomed the flexibility offered by multiple cadres, a lack of coordination and harmonisation was reported in both countries.Key conclusions: The development of midwifery education in Cambodia and Malawi is complex and somewhat fragmented. While some midwifery cadres have been trained to fulfil a more limited role with fewer competencies, in practice they often have to perform a more comprehensive range of competencies.Implications for practice: Education of midwives in the full range of globally established competencies, and leadership and coordination between Ministries of Health, midwife educators and professional bodies are all needed to ensure midwives can have the greatest impact on maternal and newborn health and wellbeing.

The last decade has seen high levels of displacement in Central America and Mexico, with women and girls representing a growing share of this flow. Women and girls face a unique set of sexual and reproductive health risks, both as a direct result of the migration process, and as a consequence of violence, conflict and oppressive gender norms in the region. This scoping review adopts a five-stage process to search for, identify, and review selected literature to answer two questions: (1) what sexual and reproductive health and rights risks, challenges, and needs do women and girls face before and during displacement; and (2) how do issues of sexual and reproductive health and rights influence women and girls' coping mechanisms and decisions in displacement in the region? Extracted data from intersecting literature on migration, gender, and health in the corridors of migration in Central America and Mexico are mapped and analyzed against a framework adapted from the Guttmacher-Lancet Commission on components of sexual and reproductive health and rights. Many Central American and Mexican women and girls flee conditions of gang-related conflict, gender-based violence, poverty, and other situations of extreme disadvantage. Findings from this study demonstrate they face further deprivation and suffering from the denial of health and rights throughout the migratory cycle. This review finds that migrant women and girls encounter considerable barriers to accessing services of sexual and reproductive health, are vulnerable to sexually transmitted infections, and face many violations of sexual and reproductive rights. Young migrants and sex workers, who are often connected with irregular migration in border areas, appear to be particularly vulnerable. Findings also reveal that the literature tends to focus on sexual health and rights, with a relative paucity of evidence on wider reproductive health issues. Of critical importance is how women and girls must constantly balance risk and opportunity in situations of constrained choice, and how their coping strategies and decisions define and influence their migration trajectories and broader wellbeing. This review identifies a gap in the literature around comprehensive studies that define sexual and reproductive health and rights beyond the confines of disease and sexual behavior, as well as a need for greater focus on under-represented migrant groups such as adolescent girls.

Despite its high profile Transition culture is only beginning to receive academic attention. This paper contributes to this by locating Transition culture within a rural studies frame, highlighting the significance of rurality to Transition culture and reflecting on the nature of its politics. Drawing on interviews with Transition activists the paper explores these questions by focussing on Transition culture in practice. It connects activists' accounts and descriptions of Transition with debates about the changing meanings of rurality, the increasingly co-constituted relationship between rural and urban spaces and with the changing forms of political action which have been identified as radical and as post-political. The paper argues that Transition culture can be seen as a convergence of rural-urban values and practices. It suggests that this is possible because of Transition culture's avoidance of an explicitly political agenda, its reliance on more consensual driven concepts such as community and, related to this, its post-political orientation. © 2013 Elsevier Ltd.

Using qualitative data from a research project investigating contemporary rural identities in England this paper examines the apparently contradictory discursive claims that are made on rural spaces. It looks in particular at the ways in which these are narrated – through the notions of rural space as a site of safety, orderliness and community on the one hand and as a site of freedom, anti-order and non-regulation on the other. While the former is a familiar, entrenched and critiqued representation of rurality, the latter narrative has a more marginal and ambivalent place in the dominant rural imaginary. Drawing on Foucault’s concepts of panopticism and heterotopia the paper demonstrates the ways in which the rural is a highly labile concept and emphasises its continual ‘unfinishedness’. However, alongside this, the paper suggests that the tensions and contradictions of the orderly and anti-orderly discourses are underpinned by a particular coherency that is driven by senses of community, belonging and self-regulation. While these do not resolve the contradictions of the discursive claims the potency of such drivers are sufficient to produce a particular inclusive spatiality which is able to accommodate and incorporate the different discursive positions and the practices that are associated with each.

This paper emerges from a current research project that examines the relationship between contemporary English rurality and notions of identity and belonging. While this is primarily a methodological narrative we argue that this narrative speaks to an analysis of current rural relations. The paper concerns itself with two key methodological issues that have arisen during the ‘doing’ of the research. First, it examines our own relationship, as ‘outsider’, urban-based researchers, to the rural and the use and/or relevance of our biographies as resources for making ourselves seem less ‘strange’ and for accessing, and being in, rural environments. At the same time as providing us with a map into our micro rural worlds the paper draws on this biographic-research relation in order to problematize notions of homogenous rural identities and polarized rural/urban identities. The second part of the paper argues that who we were/how we were perceived had a relation to what ‘truths’ and accounts we were told by our respondents. More particularly, we show how our use of focus group interviews had a direct role in the rehearsal and presentation of these ‘truths’. Given the current contestations and tensions over what and who ‘the rural’ is, it was clear that those involved in the focus group discussions wanted to give us particular stories that often fell into a consensus pattern of either ‘rural idyll’ or ‘rural crisis’ narratives. Drawing on Simmel's notion of the stranger and focus group data we argue that for these narratives to be told we, as researchers, were ascribed by the group members to shifting positions of intimacy and remoteness.