Using the birth model helped the doctors to improve their clinical skills
PharmAccess and Hygeia organized a well attended five day workshop with very positive results. The workshop ‘addressing maternal and neonatal mortality in the community’ was attended by 45 midwives and doctors from ten different clinics and hospitals in the Health Insurance Fund program in Lagos, Nigeria. The modules of the courses aimed to refresh and improve both knowledge and practical skills. For example, by training the possible complications that can occur during and after birth and by introducing critical and reflective thinking in ways to manage complications. Following the training the participants took a post-test and compared to the previously held pre-test the scores were overall excellent.
The workshop was split into two, a course for the midwives and one for the doctors. The midwife-course was hosted by the Zimbabwean midwife and professional educator Mrs. Nester Moyo and two Nigerian midwives (Mrs. Mary Folu Shusi from Lagos State University Teaching Hospital, and Mrs. Victoria Medayeyan from the Unilorin Teaching Hospital, Ilorin).
The teaching team for the doctor workshop consisted of five Nigerian gynaecologists from Lagos (Dr. Oyeneyin, Dr. Oyewunmi, Dr. Ajijola, Dr. Akin-Adenekan and Dr. Akinola) and two Dutch specialists (obstetrician Dr. Jules Schagen van Leeuwen and paediatrician Dr. Sibyl Geelen). At the same time, Hygeia, the local executing partner in Nigeria, organized another similar workshop for the midwives and doctors from the clinics in the Health Insurance Fund program in Kwara State.
WHO statistics on maternal and neonatal mortality
In developing countries maternal and neonatal mortality is an alarming problem. The World Health Organisation (WHO) report on ‘neonatal and perinatal mortality’from 2006, estimates that every year over 4 million babies die in the first four weeks of life; 3 million of these deaths occur in the early neonatal period and more than 3.3 million babies are stillborn every year. Ninety-eight per cent of these deaths take place in the developing world.
The WHO figures for developing countries on maternal mortality are as tragic. Of the estimated total of 536000 maternal deaths worldwide in 2005, developing countries accounted for ninety-nine percent (533000) of these deaths. Slightly more than half of the maternal deaths (270000) occurred in the sub-Saharan Africa region alone. Specifically for Nigeria, the maternal and neonatal mortality rates are amongst the worst in the world.
According to the WHO the health workers in developing countries often lack the skills, leading to inappropriate management of complications during the pregnancy and delivery. But part of the problem is also that these deaths are often accepted in society as part of the risk. The recognition that these problems can be tackled is of great importance, and both midwives and doctors can play a crucial role in this process.
Improving knowledge and practical skills
A great deal of the midwives course dealt with changing the perception on childbirth
The PharmAccess/Hygeia workshop addressed both these problems. The two and a half day midwife-course dealt with a variety of issues, about what midwives can do as individuals, as members of the community and as a professional organization to reduce the above stated statistics. It introduced reflective and critical thinking to encourage practice modification and to motivate change. The rational behind it is to change their perceptions on childbirth and at the same time to improve their clinical knowledge. PharmAccess and Hygeia already planned follow-up workshops for midwives later in 2009.
The course for the doctors focused at the major causes of maternal mortality. Causes such as post-partum hamorrhage, ecclampsia, obstructed labour and infections. Managing these complications was put into practice by using birth and neonatal models. This practical case management refreshed and improved their knowledge and skills and will help the participants to provide good maternal and neonatal care; an important part of their daily practice.
Participants using th birth model