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This presentation discusses the midwifery gap in Pakistan and the strategies they are using to address it.

This article examines one new element of non-government provision in Tanzania: small-scale independent midwifery practices. Because of their location and emphasis on personalized care, small-scale independent practices run by retired midwives could potentially increase rates of skilled attendance at delivery at peripheral level. [from author]

This is a QI package for the private sector that includes a review of service statistics, accompanying a QI self-assessment tool for midwives to identify quality issues, and a linked action plan for midwives and supervisors to help solve issues the QI tool identifies. [publisher’s description]

Delivery by a skilled birth attendant (SBA) serves as an indicator of progress towards reducing maternal mortality worldwide – the fifth Millennium Development Goal. Though WHO tracks the proportion of women delivered by SBAs, we know little about their competence to manage common life-threatening obstetric complications. We assessed SBA competence in five high maternal mortality settings as a basis for initiating quality improvement. [from abstract]

This study assessed whether the strategy of “a midwife in every village” in Indonesia achieved its aim of increasing professional delivery care for the poorest women. [from abstract]

Rising health care costs and the need to consolidate expertise in tertiary services have led to the centralisation of services. In the UK, the result has been that many rural maternity units have become midwife-led. A key consideration is that midwives have the skills to competently and confidently provide maternity services in rural areas, which may be geographically isolated and where the midwife may only see a small number of pregnant women each year. Our objective was to compare the views of midwives in rural and urban settings, regarding their competence and confidence with respect to competencies identified as being those which all professionals should have in order to provide effective and safe care for low-risk women.

In this discussion document, the Department of Health and Children identifies key development issues facing nursing and midwifery in the future. This is in order to establish a strong platform for the formulation of a strategic response to these issues. The document contains an insightful analysis of the challenges ahead and identifies a range of possible responses. [from preface]

Nurses and midwives face the challenge of embracing new methods of care delivery which will provide a quality service that is truly people-centred. There is growing evidence of the need to link continuing professional development with organisational goals. The construction of career pathways in a healthcare system which is subject to radical and far-reaching change is an issue of growing importance to nurses and midwives. [from executive summary]

This document introduces a competency-based curriculum for nurses and midwives in Rwanda developed by the Capacity Project.

The aims of these guidelines are to provide information about the concepts and processes essential for quality assurance of basic nursing and midwifery education in the African Region; propose a process and content for evaluating existing basic nursing and midwifery education programs; stimulate ideas for establishing a quality assurance system for basic nursing and midwifery education; guide allocation of human and financial resources in current and future programmes and services; provide well-defined international and regional standards of education. [from introduction]

Because most women prefer professionally provided maternity care when they have access to it, and since the needed clinical interventions are well known, we discuss in their paper what is needed to move forward from apparent global stagnation in provision and use of maternal health care where maternal mortality is high. To increase the supply of professional skilled birthing care, strategic decisions must be made in three areas: training, deployment, and retention of health workers. [from summary]

This model for strengthening the midwife and hilot partnership was developed to improve the quality and accessibility of maternity and newborn care services (MNCS) in the Autonomous Region in Muslim Mindanao (ARMM). It aims to provide quality MNCS at various service settings like the home, community and health facilities. [introduction]

The Centre for Health and Population Research, Dhaka, looked at the experiences of midwives attending homebirths in the rural region of Matlab. In Bangladesh, 91 percent of births still take place at home and only 13 percent are assisted by a doctor or midwife. In 1987, almost 20 years ago, a health initiative was introduced in Matlab to allow midwives to attend women in the home. Researchers conducted interviews and group discussions with 13 midwives in Matlab in 2003 and 2004 to learn what difficulties they faced during their work. [author’s description]

In 1989, the government of Indonesia launched the Midwife in the Village programme. Its purpose was to reduce maternal death by assigning a resident midwife to each village in the country. By definition, she would live in the village and be part of the community she served. In 2005, Immpact examined the effect of the programme on the health and survival of mothers in two districts in Java. [from author’s description]

This paper explores the potential for private-sector midwives to provide services beyond their traditional scope of care during pregnancies and births to address shortcomings in less developed countries’ ability to reach MDGs. This paper examines factors that support or constrain private practice midwives’ ability to offer expanded services in order to inform the policy and donor communities about PPMWs’ potential. [from executive summary]

This Royal College of Nursing (RCN) publication is designed to assist you in your role as a mentor to pre-registration nursing and midwifery students. It outlines your responsibilities alongside those of the student, higher education institutions (HEIs) and placement providers. [introduction]

These revised and expanded guidelines aim to help [national nursing associations], nursing and midwifery personnel, nurse managers, employers and others to address the educational needs and ethical responsibilities of nursing and midwifery personnel in reducing transmission of HIV/AIDS, HBV, HCV and tuberculosis; develop strategies for a safer work environment and increased protection for nursing and midwifery personnel; and address the socioeconomic welfare issues related to the health care needs, compensation and financial security of HIV-positive nursing and midwifery personnel.

This presentation was part of the 2006 Global Health Mini-University. This session will provide an overview of factors that support or constrain the delivery of expanded services by midwives. It will discuss successful case studies to build sustainable practices. This includes a program to promote business training and access to financing to grow and improve private midwife practices in the Philippines. Presenters will also discuss the use of networks for private midwives for service expansion, quality improvement, and sustainability in Kenya. [adapted from publisher’s description]

This presentation was part of the ECSACON Conference. It discusses the advantages and disadvantages of traditional teaching versus distance education for nurses and midwives.

This cost analysis is based on QAP research on the effectiveness of two interventions (self-assessment and peer review) in sustaining or increasing the effectiveness of interpersonal communications training that midwives had taken. The research had measured the effectiveness of the interventions in terms of the number of utterances midwives made during family planning consultations, and this case study followed on, measuring the cost of each intervention in terms of the number of utterances generated.

This report documents the efforts of the Institute for Reproductive Health (IRH) to integrate natural family planning methods into the health delivery system in the Phillipines. It discusses the venues used for implementation such as government and NGO partnerships as well as IRH’s training resources and activities for nurses and midwives on family planning. Finally, the report details best practices and lessons learned from the multi-year project.

This presentation discusses the AMRN role of strengthening nurses and midwives in their responses to HIV/AIDS by improving their knowledge and skills in evidence based practice, research, counseling, advocacy and education. Included is information about the magnitude of the HIV/AIDS problem and some strategies that AMRN has used to address the problem through nurses and midwives.

JHPIEGO has been working since 1991 to support the development of a national integrated clinical training system used for both family planning/reproductive health (FP/RH) preservice education and inservice training in Turkey.

JHPIEGO and the United States Agency for International Development/Ghana, has now focused on strengthening preservice education for nurses and midwives who provide FP/reproductive health (RH) and safe motherhood services. The phased strategy will ultimately strengthen preservice classroom and clinical training components in all ten midwifery training schools (MTS) in Ghana. To clarify the needs of the training institutions and guide program planning, two needs assessments were conducted at the MTS in Kumasi and Koforidua.

From 1987 to 1998, JHPIEGO, through its Training in Reproductive Health (TRH) Project, collaborated with the Association of Deans of Philippine Colleges of Nursing (ADPCN) and the Association of Philippine Schools of Midwifery (APSOM) to strengthen preservice nursing and midwifery education in the Philippines. Between 1987 and 1994, JHPIEGO initiated activities to strengthen family planning/reproductive health (FP/RH) and enhance trainer/faculty development in five nursing schools and five midwifery schools.

JHPIEGO’s strategies for strengthening Ghanaian preservice education in family planning/reproductive health and essential maternal and neonatal care have included: developing and implementing a standardized, competency-based curriculum; improving knowledge and skills of tutors and clinical trainers/preceptors; reinforcing service delivery sites used for clinical practice; and providing schools and clinical training sites with anatomic models and supporting training materials. [adapted from author]

This paper examines various aspects of the nursing and midwifery workforce in Africa, looking at education and supply systems; recruitment, retention and motivation and career systems. It further investigates attrition from migration and HIV/AIDS, as well as other factors and makes some recommendations on how to move forward using examples of experiences from countries. These experiences, albeit on a small scale, show promise of good results after being scaled up. [author’s description]

This study aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. We have used the term nursing staffing dynamics to encompass a range of human resource processes including staff turnover, absenteeism, average length of stay in a facility, vacancy rates and workload. The study was carried out in Limpopo, KwaZulu-Natal and Mpumalanga provinces in South Africa. [author’s description]

The study found that about half of the deliveries in Malawi are not assisted by a skilled attendant. It seems that there is a severe and long standing problem with retaining midwives. Therefore, close monitoring of the retention problem is advisable. The research found that the two main forms of losses are that the midwives die or they go abroad. Possible ways of mitigating the loss through emigration could be to continue efforts in enforcing codes of practice on international recruitment in recipient countries.

The purpose of these Guidelines is to assist Member Countries in strengthening the management of their nursing and midwifery workforce and, through this, to assist in strengthening health care delivery and strategies for improving health. In particular, they aim to assist Member Countries by assisting them to effectively manage nursing and midwifery issues, including the problems of continuing shortage and maldistribution of nursing and midwifery personnel along with an inappropriate skill mix. [from introduction]