December 6, 2021


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Invest in midwifery training and education to improve maternal and newborn outcomes

The critical role of midwives in improving maternal and newborn health

The risk of death during pregnancy and childbirth is greatest in resource-limited settings, and the end preventable Maternal mortality requires critical investments in frontline maternity care providers to meet the Sustainable development goal (SDGs) Maternal and newborn health (MNH) targets by 2030.

Midwives trained and regulated to international standards and working in well-equipped enabling environments provide 87% essential care services in MNH. It is believed that universal coverage of essential maternal, newborn and family planning interventions that are part of midwifery practice could prevent 83% of all maternal and newborn deaths and stillbirths. Increasing the delivery of midwifery-led care globally could translate into cost savings 4.3 million mother and newborn live every year by 2035.

During the COVID-19 pandemic, midwives remained on the front line to save the lives of women and their newborns despite challenges with personal protective equipment, work-related stress and ineffective communications. Therefore, greater investment in midwifery is a key path to achieving MDG 3 MNH targets.

The challenges of midwifery training and education

Countries are striving to scale up and provide equitable midwifery services, but comprehensive and disaggregated data to determine the availability, accessibility, acceptability and quality of midwifery personnel is not available.

Continuing professional development for midwifery educators

Evidence shows a big gap between current evidence-based standards and the competence of providers to manage certain obstetric and neonatal complications. In addition, there is evidence of significant variation in the knowledge and skills of maternity care providers by country in sub-Saharan Africa. In addition, initial training programs for midwives have been critical as being largely didactic and insufficient in low- and middle-income countries (LMICs).

Countries need to invest in midwifery training to meet current standards qualified health personnel (SHP). SHPs are competent MNH professionals trained, trained and regulated according to national and international standards (International Confederation of Midwives) and competent to identify and manage or refer women and / or newborns with complications, and can thus perform all the signaling functions of emergency maternal and newborn care. (SOU) to optimize the health and well-being of women and newborns.

To improve the skills of midwives, midwifery training programs should be reinforced to meet international standards. What is the best way to improve SHP training and education? What are the most effective ways to achieve this? What is the impact of SHP interventions? For these interventions to be effective, they must be context specific.

A structured approach to improve in-service training and education programs for midwives in Kenya

Partnerships for better training of midwives

Improving the quality of midwifery education in Kenya has been achieved through effective partnerships. Support for the search for implementation by the UK Foreign and Commonwealth Development Office in Kenya and the Johnson and Johnson Center for Health Worker Innovation.

Continuing professional development for midwifery educators

Collaboration with the Kenya Nursing Council, Kenya Council of Clinical Officers, and the Initial Training Working Group chaired by the Kenyan Ministry of Health (MoH), ensured that a comprehensive review of programs and programs for midwives and clinicians in Kenya was undertaken.

Emergency Obstetric Care and Quality of Care Unit, Department of International Public Health Liverpool School of Tropical Medicine (LSTM) developed and managed these partnerships aimed at improving the skills of SHP. This is essential for improving the quality of maternal and newborn care towards the achievement of SDG 3 targets through a health system approach in Kenya.

Midwifery training: training program and curriculum

The Kenya Ministry of Health has established the National Pre-Service Working Group to coordinate the integration of EmOC into pre-employment training for SHPs. LSTM supported the Kenya Nursing Council in 2019 to review and update midwifery training curricula to reflect current international SHP competencies incorporating EmOC.

Therefore, the midwifery program at the Kenya Medical Training College, the largest contributor of human resources for health in Kenya, accounting for over 85% of the hospital workforce, has been revised and updated.

Evaluating the Effectiveness of Midwifery Education Interventions

A cluster randomized controlled trial in Kenya, they investigated the effectiveness of an improved EmOC program, building the capacity of midwifery trainers, providing hands-on training materials, and mentoring trained midwifery educators. The trial showed a statistically significant improvement in the skills of final year midwifery students in the intervention group compared to the control group. This study was the proof of concept that led to the updating of national midwifery education programs in Kenya.

Continuing professional development for midwifery educators

As the program is now officially updated with the participation of all partners, an in-depth study to measure its effectiveness is underway in Kenya. In addition to building the capacity of midwives and clinical medicine educators, mentoring will be provided to educators and professional training materials will be provided. The Kenya experience and the results of this trial are expected to serve as a model for investments in midwifery training in other LMICs.

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