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Bakhtawar Khowaja’s research focuses on a question that lies at the heart of maternal health: how can education strengthen the systems that support the people who deliver care?
A PhD candidate in McMaster’s Global Health program, supervised by Dr. Liz Darling, Assistant Dean of Midwifery at McMaster, and a research assistant with the FLOURISH Research Group, Bakhtawar Khowaja is developing strategies to strengthen primary maternal care in low- and middle-income countries. Her research focuses on improving midwifery education and training to achieve better outcomes for women and newborns – beginning in Pakistan, where midwives are often the main providers of maternity care.
Her doctoral study builds directly on her master’s research, which explored the challenges faced by community midwives in the district of Thatta, Pakistan. That earlier work revealed significant gaps in education and training, as well as limited opportunities for professional growth and supervision. The findings informed the design of her PhD, which aims to identify interventions that strengthen midwives’ competence, confidence, and professional identity.
“Midwives are the sole maternity-care providers in many rural regions of Pakistan,” Khowaja explains. “But the gaps in education and training compromise the quality of care women receive. Strengthening education strengthens everything that follows.”
To support her research, Khowaja has received a travel award from McMaster’s School of Graduate Studies, funding her doctoral fieldwork in Pakistan. Her abstract, “Challenges faced by community midwives in rural district Thatta of Pakistan,” has also been accepted for presentation at the International Confederation of Midwives 34th Triennial Congress in Lisbon in June 2026.
Working within the FLOURISH Research Group has helped shape both her methods and perspective. “The strength of FLOURISH is its diversity,” she reflects. “Each member brings a different focus, yet we share the same goal – to improve maternal and child health outcomes. That exchange of ideas has helped refine my work and broaden its impact.”
Looking ahead, Khowaja hopes her research will contribute to stronger international collaboration in maternal health. She sees potential for partnership between the Canadian Association of Midwives (CAM) and the Midwifery Association of Pakistan (MAP) to share educational models, professional development opportunities, and leadership initiatives.
Her research is guided by a simple premise with wide implications: improving maternal health begins with those who provide it. By strengthening the systems that prepare and support midwives, Bakhtawar Khowaja’s work aims to make maternal care safer, more consistent, and more equitable – in Pakistan and beyond.
