Midwives

This article suggests that India’s maternal mortality rate is so high due to political, administrative and managerial issues such as the lack of exclusive midwifery training and professional midwives. [adapted from author]

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]

The shortage of trained health professionals is among the main obstacles to strengthening low-income countries health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. [author’s description]

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]

This presentation presents some of the issues concerning the effect of HIV/AIDS on the nursing and midwifery professions in the Commonwealth countries of east, central and southern Africa.


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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. Activities/tools: Sample provider self-assessment form, sources of costs, evaluation of marginal benefit.

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]

During the 1990s in Kenya, nurse midwives, a new group of private-sector service providers, were licensed to operate private clinics close to communities. The private nurse midwives operate private clinics, nursing and maternity homes primarily in densely populated peri-urban areas, rural trading centers and towns. The networks described in this report emerged out of the need for a sustainable supervision system and a continuing education program for the private nurse midwives. [from introduction]

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

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]

This presentation outlines a program desingned to train midwifery tutors and midwives to reduce maternal mortality.

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. In summary, this project has made substantial gains in meeting the USAID/Turkey results package from the Strategic Objective, Increased Utilization of FP/RH Services, through Intermediate Result 2, Expansion of High Quality FP/RH Services in the Public and Private Sectors, and two Sub-Results-2.1 Increased Availability of Postpartum and Postabortion FP Services and 2.3 Improved Job Performance of Health Providers, Trainers, and Administrators. It has been successful in assisting the MOH, medical institutions, and midwifery schools to establish a national, integrated training system capable of sustaining high-quality preservice education programs for interns and midwives. The inservice training system that has been established will support the MOH in their effort to expand FP/RH training to other provinces in coming years. The preservice education system will support all university-based midwifery school students by strengthening their FP/RH and maternal health skills as they progress toward their degree. [adapted from publisher]

In 1993, JHPIEGO initiated two new programs with the Association of Deans of Philippine Colleges of Nursing (ADPCN) and the Association of Philippine Schools of Midwifery (APSOM). These programs responded to the need to institutionalize clinical reproductive health/family planning (RH/FP) training, to develop a sustainable, decentralized national clinical training network for RH/FP services and to develop standardized training materials. This network was intended to increase the number of skilled graduating nurses and midwives available to meet the needs of the country. This study assessed the following outcomes in the project-affiliated schools of midwifery and colleges of nursing: institutionalization of FP training, quality of training (both classroom and clinical) and quality of services in the project-affiliated clinics. The plan also included an assessment of the institutionalization of RH/FP and the use of project training materials by all schools of midwifery and colleges of nursing. [publisher’s description]

Over the last five years, international development organizations began to modify and adapt the conventional Performance Improvement Model for use in low-resource settings. This model outlines the five key factors believed to influence performance outcomes: job expectations, performance feedback, environment and tools, motivation and incentives, and knowledge and skills. This study presents a unique exploration of how the factors affect the performance of primary reproductive health providers (nurse-midwives) in two regions of Armenia. [from abstract]

This presentation discusses the roles and challenges of private sector midwives and how they can benefit community health care.

Initial nursing or midwifery education prepares professionals for the workforce thus there is a need for programmes to be of a high quality. The development of global standards for initial nursing and midwifery education identifies the essential, critical components of education. [from author]

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 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]

In the context of the critical role that human resource play in delivering health services to populations and as human resources represent a critical constraint in achieving the targets of the Millennium Development Goals, it becomes imperative that effective systems for regulation, education, research and performance management be strengthened in order to achieve the required improvement in health outcomes. The guidelines will provide a framework to improve health programs and the services for delivering them, and to guide in allocation of human and financial resources in current and futures programs and services.

The objectives of this presentation are to: describe the context of HIV/AIDS in Zambia, describe key findings from a study to evaluate nurses’ and midwives’ knowledge of HIV/AIDS, review the study’s implications for action, and propose steps to advance workplace programs.

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This report is the result of discussions from a task force on human resources development for maternal and newborn health. The main purpose is to examine ways of strengthenig capacity at the health center level in provision of services to decrease maternal and newborn mortality. [adapted from executive summary]

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]

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. In February 2001, JHPIEGO conducted an evaluation in the Philippines to assess the impact of the preservice program since its closeout in 1998.

This presentation was part of the International Conference on Global Health session, “Integration and Application: Successes and Challenges in Health-Worker Training.” Based on the initial high MMR estimates and the low number of facility deliveries, the Ministry of Health adopted an aggressive Safe Motherhood Strategy to reduce maternal mortality as well as neonatal and child morbidity and mortality. This presentation describes this training program for nurse-midwives and details the results of a study to evaluate the program. [adapted from author]

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.

In issuing this statement, WHO, ICM and FIGO are advocating for skilled care during pregnancy, childbirth and the immediate postnatal period. This statement is especially aimed at countries in which the coverage of skilled attendance at birth is below 85%. The statement defines clearly who is a skilled attendant, what skills she/he should have and how she/he should be trained and supported. Thus a skilled attendant is an accredited health professional — such as a midwife, doctor or nurse — who has been educated and trained to proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and the immediate postnatal period, and in the identification, management and referral of complications in women and newborns.

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 report evaluates the success of the training program at 12 midwifery training schools.

In line with government initiatives, this series of studies was undertaken to establish the training and development needs of nurses and midwives working within a variety of contexts in Indonesia, with the ultimate aim of enhancing care provision within these domains. [from abstract]

Although numerous health care interventions have been implemented in Pakistan, the high maternal and neonatal mortality rates still remain a challenge. Developed countries have reduced maternal and neonatal mortality rates by improving the skill and knowledge levels of nurse-midwives. This paper reviews maternal and neonatal health issues, challenges in current midwifery education, and the role of government and international agencies in Pakistan. [from abstract]

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