Iain Smith, a member of the partership steering committee and member of the Rotary Club of Bridge of Allan and Dunblane, writes here giving a bit of background to the Midwife Training Programme the partership have been supporting through Rotary:
Background Information
Currently maternal mortality in Malawi is 675 per 100,000 live births 100 times UK
Neonatal mortality at 47 per 1,000 live births target is 155 per 100,000 live births.
The current rates of maternal and neo-natal deaths together with high numbers of women suffering from obstetric fistulas caused by pro-longed and obstructed childbirth highlight the need for sustainable and improved maternity care, delivered by fully trained and experienced professionals.
The need has been identified at a local, regional and national level within Malawi by government and health workers, as well as charities and NGOs working within the country.
When Joyce Banda came to power in 2012, she launched the Presidential Initiative on Maternal Health and Safe Motherhood (SMI) to help reduce maternal and neonatal morbidity by increasing the availability of and accessibility to good obstetric care, delivered by trained staff.
Increasing the numbers of skilled and trained midwives will ensure that women are cared for during pregnancy and have the ability to come to health clinics thus reducing the risk of obstetric fistula and maternal and neo-natal deaths.
A key objective of this initiative is working with Chiefs and local communities to educate them about the need for better maternity care. Through this, representatives from the Safe Motherhood Programme, in conjunction with senior community elders are able to help identify and recruit the trainee midwives.
Seven waiting shelters are being constructed in the highest need areas close to existing health clinics to ensure good monitoring of pregnant women enabling them to stay at the shelters during the final stages so that they can deliver with appropriate medical expertise. A further building programme of waiting shelters is likely to follow.
The Freedom From Fistula Foundation's Involvement
The Freedom From Fistula Foundation was set up by Ann Gloag OBE in 2008 to help women in Africa suffering from Obstetric Fistulas. The Charity's aim is to help these women by providing free surgeries to heal their fistulas, free maternity care to prevent fistulas and ensure safe childbirth, and training of local healthcare workers.
The Charity has worked in Malawi for a number of years and in 2012 President Joyce Banda opened their new 35 bed unit at Bwaila Hospital – The Fistula Care Centre. The unit has its own dedicated operating theatre, as well as a day room for patients which is used for teaching skills such as sewing and training the patients in basic literacy and numeracy. Staff there are all Malawian nationals except an American fistula surgeon. The unit has the capacity to treat more than 400 women every year. It also provides micro-enterprise, micro-agriculture and confidence building, as well as enterprise training and loan/saving/insurance facilities through a partnership with Opportunity Bank. The Freedom from Fistula Foundation Clinical Director (Africa), Jude Holden, is a trained midwife.
Ann Gloag personally funded the first class of trainees and the support from Rotary Clubs across Scotland, resulting in the recent Global Grant, has ensured that funding is in place to start the identification and recruitment of potentially two further classes of students (dependent upon class size).
The Training Programme
The training, over approximately 20 months, combines classroom based theory with practical training and an internship (with mentoring) of at least six months. The training has been accredited by the General College of Malawi, ensuring that trained midwives will have to remain in Malawi to work.
The syllabus for the training programme covers carefully selected courses which will help the trainee midwives to assume different roles in the community and to meet midwifery needs and address problems of the community.
Once the trainee midwives have successfully completed the course and acquired the requisite qualifications to be enrolled and licensed to practice midwifery, midwives will be deployed in rural community settings where the need is greatest.
A document outlining more about the background of this project can be viewed here.
