Up-scaling Nursing and Midwifery Education to Improve Maternal and Newborn Health in West Africa

Botswana, Malawi, Lesotho, Cameroon

This project aimed to increase the number of births attended by skilled nurses and midwives, thereby reducing maternal and child mortality and improving maternal and new-born health. The outcomes of the project will be in support of MDG4 (reducing child mortality) and MDG 5 (improving maternal health). The seminars were attended by administrators and tutors from the three sites as well as nursing and midwifery leaders from the WHO country offices, WHOCCs, MOH, and Nursing and Midwifery Councils from each country represented. This five-year collaborative project, initiated in 2015, provided support to national governments and made positive contributions to the professional education of the health workforce and to population health. In four African countries, it focused on enhancing the quality of midwifery education by improving the competencies of midwifery educators and establishing Laboratories of Change (LoC) and a Centre of Excellence (CoE) for midwifery education. Laboratory of change as operationally defined in this project implies an institution that has a systematic, collaborative approach to progressively improve midwifery education and practice through the development and application of midwifery competencies in four categories; leadership, resources, innovation and community engagement. A Centre of Excellence is an institution that achieves and maintains a systematic, collaborative approach to improving midwifery education and practice through the development and application of midwifery competencies in all the four areas mentioned above. The project set benchmarks for both statuses, and a threshold for attaining each of them. The threshold for Laboratory of Change is 50% and 75% for Centre of Excellence with flexibility across the categories, leaning towards specific strengths of a particular site based on benchmarks within each category. The WHO educator core competencies were the foundation of all of the project activities. The project achieved its objective to train midwifery educators on competency based education. The educators attained competency and students are engaged in active learning. Midwifery students appreciate the way they are taught and are motivated to perform better. More practice sites have been availed to students and there is good coordination between classroom and clinical teaching with more engagement of staff in practice sites supporting mentoring of students. The changes in perspective among educators and faculty heads of midwifery programmes is evident. The sites are seeking to innovate, transform and continue to be agents of change. There is increased institutional visibility and participation in local, national and international educational and research events. New partnerships beyond the traditional ones have been forged and strengthened. The project is a model for strengthening existing partnerships beyond government institutions. Constraints noted during the evaluation included problems of poor internet connectivity which renders access to updated information difficult. The facilities for learning in some sites are inadequate for the number of students enrolled and the faculty numbers are not optimal. In addition, some sites experience a high turnover of staff. Taking cognizance of, and working to resolve the constraints identified will help the participating institutions to continuously work towards maintaining their Centre of Excellence status. The institutions and partners can work towards mitigating the constraints beyond the life cycle of this project. Furthermore, greater focus should be placed on bringing the Kanye site up to the level of the other institutions as it has the requisite potential and capacity.