Chilean Center Leads on Midwifery Development
Newly Designated Center of Excellence Provides Quality Training on Midwifery
In spite of the many advances in health care, women and infants continue to die at childbirth. These deaths are nearly always preventable whenever the caregiver has the knowledge and skills to attend a normal birth and to manage the unexpected complications which occur in 10% of the cases. Qualified midwives and nurses with midwifery skills are being trained and recruited in many countries to address the need for skilled attendants at every birth. However, scaling up training requires the identification of institutions with quality education and mechanisms for successfully deploying newly trained staff.
Strengthening midwifery and nursing to improve skilled attendance at birth has been one of the strategies that PAHO and USAID have been promoting and supporting for a number of years. In order to move the initiative forward, PAHO and USAID have partnered with Centers of Excellence and other midwifery and nursing organizations to create the Collaborative Partnership for Achieving Improved Maternal and Newborn Health in the Americas through Nursing and Midwifery, known as the Collaborative Partnership. Existing WHO/PAHO Collaborating Centers in Nursing and Midwifery and teaching institutions with midwifery programs were also invited to join the effort. Activities included training of human resources, development of materials, strengthening of educational programs and support for professional associations in their effort to improve care. However, it soon became clear that there was a need to attract additional partners, especially in Latin America, with a specific focus on midwifery development. Following the publication of a case study on Chile’s success in reducing maternal mortality which included a chapter on the contribution of midwifery, the School of Midwifery at the University of Chile was invited to begin a trial period to become a WHO/PAHO Collaborating Center.
During the trial period the School of Midwifery successfully carried out a number of PAHO sponsored activities. The School led the translation and adaptation of the WHO Midwifery Tool Kit for Latin America, participated as experts on maternal health and midwifery in international meetings, served as consultants for improving pre-service education and training programs in several countries and became an active member of the Collaborative Partnership. On January 17, 2008, they were officially nominated as a WHO/PAHO Collaborating Center for the Development of Midwifery. The Collaborating Center has been very active in 2008 with new and continuing projects. An innovative program for training 12 Bolivian midwives is the centerpiece of a plan to create 3 new midwifery education programs to increase access to skilled attendants in that country. Recently the Collaborating Center was chosen by WHO to provide leadership for the development of Spanish language communities of practice in the Knowledge Gateway. The Collaborating Center has also agreed to coordinate the work of the 22-member Collaborative Partnership on behalf of PAHO for the next several years. With strong leadership and committed staff anything is possible.
Bringing skilled birth attendants to where they are needed the most
Midwifery course at the University of Chile trains nurses to improve maternal and neonatal health in rural areas.
Yola, one of the 12 Bolivian nurses receiving midwifery training at the University of Chile, has just finished caring for a woman during labour and delivery. USAID has supported Yola and 11 other Bolivian rural nurses in improving their midwifery skills to save the lives of mothers and newborns when they return to their country. The sacrifice of being away from her child and husband will pay off with the safety of the mothers and newborns in Yola’s community of Muyupampa.
Bolivia remains one of the countries with the highest maternal and neonatal mortality rates in the Latin American Region. In the Bolivian rural community of Muyupampa, where Yola and her family live, a newborn dies in every 14 births and a woman dies in every 212 deliveries as a consequence of complications during pregnancy, labor and delivery or postpartum.
In order to improve access to skilled attendants at birth, the PAHO Latin American Center for Perinatology and Human Development (CLAP) and USAID, jointly with other United Nations agencies, have supported a training initiative to improve the perinatal skills of 12 Bolivian nurses, including Yola. These agencies are advocating for political support from national authorities to implement a national policy to strengthen midwifery training.
The 3-year training course is being offered by the University of Chile, a new WHO/PAHO Collaborating Center. The trained nurses are expected to return to Bolivia by 2010 and use the knowledge acquired to train additional nurses in their own communities. Meanwhile high quality curricular undergraduate midwifery training with life saving skills is expected to develop in Bolivia.