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COMMUNITY MIDWIFERY assistant TRAINING IN MALAWI. PRESENTED BY SUSAN. PRESENTATION OUTLINE. BACKGROUND RATIONALE FOR INTRODUCING CMA? SUCCESSES CHALLENGES. BACKGROUND. The Millennium Development Goals 4 and 5 focus on improving maternal and child health.
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COMMUNITY MIDWIFERY assistant TRAINING IN MALAWI PRESENTED BY SUSAN
PRESENTATION OUTLINE • BACKGROUND • RATIONALE FOR INTRODUCING CMA? • SUCCESSES • CHALLENGES
BACKGROUND • The Millennium Development Goals 4 and 5 focus on improving maternal and child health. • In Malawi, Shortage and poor retention of midwives is a challenge for achieving these MDGs. • This also contributes to a shortfall in skilled birth attendants.
BACKGROUND • One mechanism developed by Malawi government to try to increase skilled attendance at birth, particularly in rural areas, was the introduction of CMA training (18-month training programme).
BACKGROUND • CMA training started as a pilot program in 2011 • 25 female students enrolled at St. Joseph’s College of Nursing and Midwifery • 23 at St. Lukes College of Nursing and Midwifery • All deployed now • Currently enrolled at St. Joseph, MCHS, Ekwendeni, st.Johns, Mulanje, Phalombe, St.Lukes, Nkhoma.
RATIONALE • To reduce MMR currently 675/100 000 live birth and neonatal mortality rate 33 per 1000 live births • To increase skilled birth attendants in the rural areas.
RATIONALE • 80% of population live in rural areas • Challenges to access health services due geographical and infrastructure problems
RATIONALE • Many midwives refuse to work in rural settings • CMA understands community cultural background. • CMAs stay in communities
successes • CMAs are adding to number of skilled attendants in the communities. • Curriculum revised to incorporate care of emergencies
SUCCESSES • Mentorship training for NMTs to mentor CMAs • Support from local organisations.
challenges • No grass root level infrastructures for CMAs to practice close to their communities. • Retention of CMAs poses a challenge as most of them are young and will get married or want to continue with education.
CHALLENGES • Mentors not always available to give the necessary support • Recruitment done at a district level and not at local level. • Curriculum still in draft form.
recommendations • Provision of infrastructures for CMAs to practice in their communities after six months of working with a mentor- this will improve access to skilled attendance at grass root level.
recommendations • Finalise curriculum • Revise retention strategy
MALAWI • ZIKOMO