By Kemo Cham
Sierra Leone is reviewing its curriculum in the training of midwives, a crucial component in the country`s effort to cut down on its discouragingly high rates of maternal and infant deaths.
The review, according to health officials, has been informed by the need to ensure quality assurance measures by producing skilled birth attendants.
Despite recent improvement, following the 1991-2002 civil war which wrecked the country`s health infrastructure, Sierra Leone still has one of the worst maternal mortality rates in the world, currently at 1,165 deaths in 100,000 live births, according to figures from the Ministry of Health and Sanitation (MoHS).
The training of Midwives is one of the key interventions geared towards changing these gloomy statistics and ensure the provision of sexual reproductive health services at all level of care, say officials.
The NSM, situated in the heart of the Princess Christian Maternity Hospital, commonly referred to as Cottage Hospital, located in the east end of the capital, Freetown, is one of only two midwifery schools in the country. The second school is located in Makeni, in the northern region of the country. Between the two they produce on average a 100 midwives annually.
The objective of the review is to reflect present trends and innovative approaches in midwifery education and practice, to enable the health system respond to the emergence of new diseases and changing client health needs, says Dr. Joan Shepherd, Principal of the National School of Midwifery (NSM), according to a statement from the MoHS Public Relations Office.
Dr. Shepherd was speaking at a just concluded two-day Midwifery Curriculum Review session hosted by the school and funded by the United Nations Population Fund (UNFPA).
The new modules being developed for inclusion into the curriculum are subject to the approval by the Nurses and Midwives Board of Sierra Leone, which has welcomed the review process.
UNFPA Country Representative, Dr Bannet Ndyanabangi, says handling maternal and newborn care called for a strong health systems and adequate human resource capacity, his organization`s inclination to support.
The UNFPA boss says, citing the 2010-2015 National Health Sector Strategic Plan of the MoHS, that shortly before the 2014 Ebola epidemic, Sierra Leone had only 95 midwives when it needed 300. He says since then over 300 midwives have been trained in both the Makeni and Freetown schools.
The UN agency is supporting midwifery education with over 125 new intakes this year and 149 continuing students in terms of tuition, quarterly allowances to students, and provision of teaching and learning equipment to skills, laboratory and supportive supervision during clinical placement.
UNFPA will ensure that skilled and qualified service providers are available to offer delivery services through training of doctors, midwives, Nurse-Anaesthetists and Community Health Officers as Non-Physicians Clinicians, thereby enabling them to provide Emergency Obstetric Care services by way of task shifting, Dr Ndyanabangi says.
Inadequacy in competent midwives in Sierra Leone poses a damaging effect in the survival of mothers and their newborns, says Dr. Santigie Sesay, Director of Reproductive and Child Health, MoHS. He adds that this has contributed to the poor health status of would-be mothers, leading to devastating outcomes including disability and deaths, with many newborns losing their lives as they enter into the world.
"As a ministry we have done a lot by improving the health of the vulnerable women and children through the free health care and its complementing programmes and projects such as the Performance Base Financing (PBF) Scheme, among others,” states Dr Sesay.
“The growing gains have been severely reversed with the Ebola Virus Disease outbreak. Without any attempt in enumerating some of the negative effects, which I reckon you all aware of; it is but important to emphasize that much is needed in our collective effort to regain those losses and by extension building a resilient health systems."
According to Chief Nursing Officer, MoHS, Matron Hossinatu Kanu, nurses and midwives constitute 76 percent of the health workforce. She says as a way of reforms in the nursing profession, the Ministry developed five pillars, among them patient and health worker safety, health workforce, essential health services, community ownership, and information and surveillance.
The ministry has also developed and is implementing plans for career pathway geared towards upgrading the level of nurses and midwives, she adds.
(C) Politico Online 02/10/15
