Midwifery in Malawi. In-depth country analysis

Size: px
Start display at page:

Download "Midwifery in Malawi. In-depth country analysis"

Transcription

1 Midwifery in Malawi In-depth country analysis Prepared by Andrea Nove May 2011 This analysis has been prepared as a background document to The State of the World s Midwifery Report 2011 The recommended citation is Nove A. Midwifery in Malawi: In-depth country analysis. May Background document prepared for the State of the World s Midwifery Report Unpublished. Disclaimer: While all efforts have been made to verify the information in this report, responsibility for the contents and presentation rest with the author. The views and opinions expressed in the report do not necessarily correspond with those of the State of the World s Midwifery Report 2011 Editorial Committee, nor with those of the government of the country.

2 1 General data 1.1 introduction Midwifery in Malawi: In-depth country analysis Malawi became an independent state in Since it adopted a strategy to eradicate poverty in 1994, it has introduced free primary school education, a free market economy, a bill of rights, and a parliament with three main parties. In 1994 it also adopted the National Population Policy, which aimed to improve family planning and health care programmes, to increase school enrolment with an emphasis on raising the proportion of female students to 50% of total enrolment, and to increase employment opportunities, particularly in the private sector 1. With a population of 15.4 million and a population density of 130 per square kilometre, Malawi is densely populated relative to the rest of sub-saharan Africa. It has an exceptionally young population, with nearly half of its people (45.9%) aged under HIV/AIDs is very prevalent in 2006, just eight countries had a higher proportion of HIVinfected adults 3. With a predominantly agricultural economy, only 15% of Malawi s population is classified as urban, making it one of the least urbanised countries in Africa. Administratively, the country is divided into three regions: North, Central and South. According to the World Health Organisation (WHO), in 2006 Malawi s expenditure on health was US$70 per capita, representing 12.3% of GDP 4. According to UNICEF, 7% of central government spending between 1998 and 2008 was on health 5, but according to DFID, this went up to 12.3% in 2008/9 6 and the 2010/11 budget projected that 15.5% of spending would go to the health sector General indicators Table 1: General population indictors for Malawi Demographic and health highlights Population mid ,400,000 Rate of natural increase (%) 2.9 Projected population, ,900,000 Projected population, ,400,000 Infant deaths per 1,000 live births 80 Lifetime births per woman (total fertility rate) 6.0 Life expectancy at birth, male 48 Life expectancy at birth, female 50 HIV/AIDS among adult population, ages 15-49, 2005/2006 (%) 11.8 GNI PPP per capita, 2005 (US$) 650 Density (population/sq. km.) 130 Ever-married females ages (%) 37

3 Family planning Contraceptive use among married women, all methods, ages (%) 41 Unmet need for family planning (%) 30 Indicators on women Births attended by medically trained personnel, poorest fifth (%) 43 Births attended by medically trained personnel, middle fifth (%) 51 Births attended by medically trained personnel, richest fifth (%) 83 Births attended by skilled personnel (%) 56 Maternal deaths per 100,000 live births, ,800 HIV-infected adults who are women population, (%) 57 Literacy rate, ages 15-24, , female (%) 71 Literacy rate, ages 15-24, , male (%) 82 Secondary school enrolment, female, 2000/2004 (as % of school-age 29 enrolment) Secondary school enrolment, male, 2000/2004 (as % of school-age 37 enrolment) Sources for statistics: 2006 World Population Data Sheet, PRB; Women of Our World 2005, PRB; The Wealth Gap in Health, PRB; Making the Link: Population, Health, Environment, PRB; and Family Planning Worldwide 2002 Data Sheet, PRB; World's Youth 2006, PRB. (Population Reference Bureau, Specific national data emanating from national survey are indicated where needed. Although the above table shows that 29% of secondary-school-age girls enrolled in secondary school, the 2009 Malawi Welfare Monitoring Survey 8 found that 6% of secondaryschool-age girls who had been in school the previous year had dropped out (similar to the 5% recorded for boys). An annual drop-out rate of 6% over the four years of secondary school age (14-17) would translate to approximately 23% of girls finishing secondary school (compared with approximately 30% of boys). This will impact negatively on girls future health and economic prospects, and also on the pool of educated women available to train as maternity care providers. The 2009 Welfare Monitoring Survey found that the main reason for year-old girls not being in education was that they were married. 1.3 MMR over time Malawi s maternal mortality ratio (MMR) is high (510 per 1,000 live births in 2008), with a lifetime risk of maternal death of 1:7 9. Table 2 shows that the MMR fell by 44% between 1990 and Progress towards MDG5 has been faster since 2000, with an annual percentage change of -4.2% between 2000 and 2008.

4 Table 2: Evolution of Maternal Mortality Ratio (MMR) Estimated MMR % Change in MMR between 1990 and 2008 Annual % change in MMR between 1990 and Source: UNICEF ( Despite the relatively steep fall in Malawi s MMR since 2000, Figure 1 shows that Malawi will not achieve its target under MDG5 unless the MMR starts to fall more sharply than it has over recent years. Figure 1: Evolution of Maternal Mortality Ratio (MMR) compared to the desired evolution to attain MDG5 Demographic and Health Survey (DHS) MMR estimates are somewhat different to the UNICEF figures quoted above (984 in 2004, 1,120 in 2000 and 620 in 1992), and these figures are widely quoted in the literature.however, the 2004 DHS report noted that: It is unlikely that maternal mortality has gone up and then down again so dramatically, especially since the reference periods for the estimates overlap each other. Maternal mortality ratios measured in this way are subject to very high sampling errors and cannot adequately indicate trends over the short term. 1.4 SBA percentage over time The UNFPA figures in Table 3 indicate that, in recent years, just over half of deliveries in Malawi have been attended by a skilled birth attendant (SBA):

5 Table 3: Trends in the percentage of deliveries attended by SBA, * 2006** 2007** 2008** 2009** 2010** 56% 61% 61% 54% 54% 54% * From Women of our World 2005 ** From State of the World Population Report for the respective years Figures from Demographic and Health Surveys (DHS) are based on live births rather than all deliveries, and are broadly similar to those shown above. Additionally, DHS figures (see Figure 2) indicate that the proportion of live births attended by skilled health personnel has not changed significantly since Figure 2: Trends in the percentage of live births attended by SBA, The 2004 DHS found that 50% of live births were attended by a nurse or midwife, and 6% by a doctor/clinical officer. Correspondingly, 57% of live births took place at a health facility. Women living in urban areas were much more likely than those living in rural areas to be attended by a SBA (84% and 53% respectively in 2004). This imbalance in access to SBAs between urban and rural areas has been evident in all DHS surveys since 1992, and the gap has not narrowed over time 10.

6 2 History of midwifery 2.1 Historical heritage, first midwifery training At independence in 1964, the only registered nurse/midwives in Malawi were those who had trained in other countries. The Kamuzu College of Nursing (KCN) was the first Malawian training institution, opening its doors in Since the mid-1960s, the Nurses and Midwives Council of Malawi has maintained that the training of nurse/midwives should prepare them to perform functions that, in developed countries, would normally be provided by physicians, e.g. starting intravenous fluid and attending high-risk deliveries. This is due to there being a more severe shortage of physicians than of nurse/midwives (see Section 4.4). This has resulted in the evolution of specialist nurse/midwife roles, especially in relation to the care of women and children Evolution of the framework for midwifery services Malawi was one of the first African nations to have developed a Road Map for maternal and neonatal health. The Road Map was first developed in 2005, and was updated in According to UNFPA 12, Malawi was one of only two countries to have secured more than 50% of the required funding for the implementation of the first phase of the plan. The Road Map identified several contributing factors to Malawi s high MMR, of which the four most important were: (1) staff shortages and weak human resource management, (2) limited availability and utilisation of maternal health care services, (3) weak referral systems and (4) weak community participation and involvement. In the Road Map, the Government recommended a minimum health expenditure of US$17.53 per capita per year, significantly higher than the US$12 that was estimated in The Ministry of Health (MoH) produced a six-year pre-service training plan to run from , with the aim of increasing the supply and improving the distribution of essential health service providers. In 2003, the Health Service Commission (HSC) was established, with responsibility for filling health worker vacancies. From , a Safe Motherhood Project (SMP) was run in the Southern region, but failed to achieve the desired outcomes. According to DFID, this failure was largely due to lack of SBAs 6. In response to the continuing shortage of qualified health professionals, the MoH launched an Emergency Human Resource Programme (EHRP) to run from , with funding of US$273 million 13. A National Health Sector Deployment Policy was produced in 2008, with the goal of attracting, training and retaining adequate numbers of health workers and to ensure they are distributed appropriately across the country. A Sector Wide Approach (SWAp) was adopted in 2004, to co-ordinate the activities and expenditure of all health development partners. According to DFID, over the years , US$735 million was allocated to the SWAp, representing about half the amount that WHO estimated was required to achieve the MDGs 6. Through the SWAp, an Essential Health Package (EHP) has been provided, comprising interventions against 11 health conditions, one of which is poor reproductive and neonatal health. Malawi was one of the first countries to sign up to CARMMA (Campaign for Accelerated Reduction of Maternal Mortality) in One of CARMMA s objectives is to accelerate actions aimed at the reduction of maternal mortality in Africa.

7 3 Midwifery situation 3.1 Who provides midwifery services In Malawi, midwifery is not a separate discipline from nursing, which makes it difficult to estimate the numbers of health professionals with midwifery expertise. Between 1979 and 1990, all students on the nursing BSc degree undertook a year s midwifery training, but since 1990 midwifery training has not been compulsory on the BSc course (see Section 5.2). There are two cadres of nurse/midwife: those who have passed the BSc course (registered nurse/midwives) and those who have a diploma in nursing (enrolled nurse/midwives). The 2008 Health Worker census reported that there were three times as many registered nurse/midwives as enrolled nurse/midwives (2,928 and 968 respectively) 13. Most nurse/midwives have midwifery skills (79% in ). Traditional Birth Attendants (TBAs) have traditionally been very active, especially in rural areas. In 1976 a training course for TBAs was launched in Lilongwe, and in 1982 the course was rolled out nationally. By 2008 it was estimated that there were about 5,000 TBAs, of whom about 2,000 had received formal training Practices and beliefs what is the place of the TBA and of the SBA, and how do people deal with pregnancy and birth TBAs tend to be highly respected in rural areas, despite a perception among health professionals that the care they provide is of poor quality due to low literacy, poor supervision and old age 14. In 2007 TBAs were banned from providing maternity care due to concerns about their lack of skills, but anecdotal evidence indicated that they were continuing to practise in secret. In 2010 the ban was lifted because the government felt that it was better to train TBAs than to forbid them from practising. Whilst some traditional practices in Malawi are beneficial to reproductive health (e.g. the practice of a female relative coming to support the pregnant women in late pregnancy and early motherhood), other practices are injurious to maternal health.many women are disempowered both economically and in terms of their ability to seek health care. Women tend not to make decisions about how to spend family income. Delay in seeking maternity care is common, because women have to wait for male family members to decide whether or not they should seek care 15.In some parts of the country, pregnant women are discouraged from eating eggs and offal, which are often the cheapest sources of protein. Abstinence from sexual intercourse is often recommended for the final trimester of pregnancy and up to six months after the birth, which can lead to men seeking sexual relations outside of marriage and therefore to transmission of STIs Role of the private sector in the provision of midwifery services Primary care is provided at health centres, health posts, dispensaries and rural hospitals. Secondary care is provided at district hospitals. Central and private hospitals provide specialist services. Two main agencies provide nearly all of the health care services in Malawi: the MoH and the Christian Health Association of Malawi (CHAM). Other services are run by the Ministry of Local Government (MoLG) and NGOs. Table 4 shows that, in 2008, 63% of the country s health facilities were owned by the MoH (including all the central and district hospitals) and 26% were owned by CHAM:

8 Table 4: Number of health facilities, by ownership, 2008 Ministry of Health (MoH) Christian Health Association of Malawi (CHAM) Ministry of Local Govt (MoLG) Banja La Mtsogolo (NGO) Other NGO Total Central hospital District hospital Mental hospital Rural hospital Health centre Clinic Maternity centre Rehabilitation centre VCT centre Dispensary Total Source: Ministry of Health HMIS Unit, 2008 Figure 3 shows that the majority of professional nurse/midwives (64.5%) were employed by the government, with 21.5% employed by CHAM and 14.0% by the private sector. By contrast, half of general medical practitioners were employed in the private sector. Figure 3: Employers of general physicians and professional nurse/midwives, Malawi, 2008 Source: 2008 Health Worker census

9 4 Numbers, distribution and movements 4.1 How many maternity care professionals are in the country? The 2008 Health Worker Census 13 reported that there were 20,908 health workers, including 2,739 management, administrative and support staff. Excluding these 2,739 workers, there were 1.39 health care providers per 1,000 population. Among these, there were 2,928 nursing professionals (i.e. registered nurse/midwives) and 968 nursing associate professionals (i.e. enrolled midwives), totalling 3,896, or0.30 per 1,000 population. As noted in Section 3.1, 79% of nurse/midwives are estimated to have midwifery skills, which translates to about 3,080 midwives. 4.2 How are midwives distributed per region? Figure 4 shows that the geographical distribution of nurse/midwives by administrative region broadly mirrors the population distribution, with most practitioners being based in the more densely-populated Central and Southern regions. The distribution of nurse/midwives is, however, slightly skewed towards the Northern and Southern regions, with just 37% of professional nurse/midwives being based in the Central region despite it being home to 42% of the population. By contrast, 53% of general physicians are based in the Central region. Figure 4: Regional distribution of general physicians and professional nurse/midwives, compared with regional population distribution Source: population figures from 2008 population census, health professional figures from 2008 Health Worker census Although Figure 4 shows that the overall regional distribution of maternity care professionals broadly mirrors the distribution of the population, Figure 5shows that the vast majority of these health professionals are based in urban areas, whereas the vast majority of the population is based in rural areas. This indicates extremely restricted access to suitably qualified health professionals among rural women in Malawi.

10 Figure 5: Regional distribution of general physicians and professional nurse/midwives, compared with regional population distribution Source: population figures from 2008 population census, health professional figures from 2008 Health Worker census 4.3 Attrition, retirement, abandon, migration MoH figures from showed that 64% of the established nursing/midwifery positions in Malawi were vacant. A 2003 study 17 quoted figures from the MoH which suggested that only 53% of registered nurse/midwife posts and 82% of enrolled nurse/midwife posts were filled. Although these estimates are quite different, it is clear that there is a severe shortage of nursing/midwifery staff. The 2003 study found that the two main reasons for nurse/midwives leaving nursing/midwifery jobs in Malawi were death (a large proportion of which occurred before the age of 45 and were almost certainly HIV/AIDs-related) and migration. The 2006 World Health Report estimated that 453 nurse/midwives who had trained in Malawi were working in OECD countries, representing 4% of the Malawian nurse/midwife workforce. It has been suggested that reasons for migration are more to do with push factors than with pull factors, i.e. the poor working conditions and remuneration in Malawi are a stronger influence than the better pay and conditions available in developed countries If so, migration is part of a vicious circle, because as the more experienced personnel leave the health facilities, the working conditions of the remaining personnel worsen, which in turn makes them more likely to leave What are the needs? The World Health Report recommended that, to achieve 80% skilled attendance at birth, there should be at least 2.3 professional care providers per 1,000 people. However, a ratio of health care providers to the size of the population will be inaccurate in a high-fertility country such as Malawi, so it is more appropriate to consider the ratio of care providers to births. Overall, WHO suggests a ratio of one midwife for every 175 births per year, assuming: a compact population, each midwife spends all her time on midwifery and only the bare minimum of care is provided 20. The Malawi National Statistical Office (NSO)

11 estimates 660,000 births in 2010 and 740,000 in This translates to the need for 3,771 midwives in 2010 and 4,228 in As noted in Section 4.1, in 2008 there were 2,928 nursing professionals and 968 nursing associate professionals, making a total of 3,896, of whom about 3,080 had midwifery skills. Even if all of these spent all or most of their time on midwifery (which is highly unlikely), this represents a significant shortfall. Furthermore, the World Health Report stated that there should be 4 doctors for every 3,500 births. This translates to the need for 754 doctors in 2010, and 845 in There were just 190 general medical practitioners and 67 specialist medical practitioners (total = 257). This large discrepancy means that nurse/midwives will be expected to provide far more than the bare minimum of care due to their having to care for the more complicated cases who ideally would be attended by a specialist physician. In 2008 the MoH started work on projections of health workforce requirements, but did not complete the exercise 13. Before the project was stopped, the MoH had estimated that, by 2017, Malawi would need: 2,834 professional nurses, 20,091 associate nurse/midwives (not all of which would specialise in midwifery) and 580 doctors.

12 5 Midwifery education 5.1 Institutions for midwifery education (public, private and capacity) The Kamuzu College of Nursing (KCN) and Malawi College of Health Sciences provide registered nurse/midwife training. Several other institutions provide training for enrolled nurse/midwives, most of which are run by CHAM 13. According to the Mzuzu University website, about 50 registered nurse/midwives graduate each year. Figure 6 shows that in the years , the number of entrants to the nursing training institutions was far lower than the number of graduates, indicating that numbers of graduates in the coming few years will be smaller than in recent years. Constraints on intake are reported to include a lack of student accommodation, too few tutors and inadequate classroom space 18. Figure 6: Numbers of entrants and graduates at nursing training establishments, Source: Training School Submissions, August Curriculum The KCN training consists of a four-year BSc course, which may include a one-year midwifery course (this used to be compulsory but since 1990 has been open only to those demonstrating an interest in and aptitude for midwifery) 18. The curriculum is described in Table 5:

13 Table 5: Subjects covered in KCN Nursing BSc course Year Curriculum 1 English language and communication; Sociology; Chemistry & Physics; Medical Microbiology & Parasitology; Human Anatomy & Physiology; Introduction to Nursing; Fundamentals of Nursing; Health Assessment; Clinical Nursing 2 Pharmacology; Medical/Surgical Nursing; Biochemistry; Community Health Nursing; Principles and Practice of Education; English Language & Communication; Statistics; Professionalism; Human Nutrition; Clinical Nursing 3 Medical/Surgical Nursing; Community Health Nursing; Mental Health/Psychiatric Nursing; Paediatric Nursing; Principles of Management; Clinical Nursing 4 Research Project; Community Health Nursing; Medical/Surgical Nursing; Clinical Preceptorship Source: KCN 23 In addition to the 4-year BSc course, KCN also offers a two-year BSc course to people who already hold a diploma in nursing, a certificate in midwifery and who have at least two years practical experience 18.Enrolled nurse/midwife courses last for three years. 5.3 Teachers and tutors (ratio to students, skills) In the 1990s, there was great concern over low nursing/midwifery tutor retention rates in Malawi, and in 1997 the MoH instituted a salary supplement scheme, funded by overseas donor organisations. The scheme had a positive effect on tutor numbers in CHAM training institutions,which went up from 43 in 2000 to 100 in With approximately 500 students enrolling per year for a 3-year course, this is a ratio of 1 tutor per 15 students, against anmoh target of 1:10. Furthermore, the overall ratio disguises the fact that some classes are very large, with students in a class 24. In 2001 there were 57 teaching staff at KCN Supervision and support, in-service training The MoH has a Human Resources Development policy, which contains eligibility criteria for in-service training via short competency-based courses and long-term professional development programmes.

14 6 Regulation, status and legislation 6.1 Regulation and status of the profession (presence of a Board or Council) The Nurses and Midwives Council (NMC) of Malawi is the sole regulatory body of nursing and midwifery education, training, practice and professional conduct of nursing and midwifery personnel in the country. The Council has a mandate to formulate professional education and/training standards and to regulate health services based on professional standards, and is currently working towards this 26. The overall objective of the Council is to develop, maintain, monitor, evaluate and control the profession of nursing and midwifery thereby contributing to the national health goal of raising the health status of Malawians. Its Mission Statement is: The council exists to ensure that the public receives quality and ethical (safe and competent) nursing and midwifery care/services through determining,monitoring all matters affecting the education, training and practice of persons in and the performance of the practices pursued, by nurses and nursing technicians. 27 All nurse/midwives are required by law to register with the NMC. In 2005 NMC figures showed that there were 3,633 practising nurse/midwives in Malawi, 1,838 non-practising nurse/midwives and 162 working abroad Professional organisations / associations/unions/colleges The Association of Malawian Midwives (AMAMI)was established in 1997 and has about 300 members, despite membership being open to all midwives regardless of employer, even if they are still in training, retired or working in a different profession 29. AMAMI collaborates with its counterpart organisation for nurses and the ICM, but does not have formal partnerships with these or other organisations. AMAMI s stated mission is to: Safeguard and promote a safe environment for mothers, neonates & their families Safeguard and promote the interest of midwives as unique & and critical health care professionals Be an official voice for midwives Be a link between midwives & government & other stakeholders As the only professional association for midwives, AMAMI has the potential to be highly influential. However, with no dedicated office or secretariat and the need to lobby a government with many conflicting demands on its resources, AMAMI struggles to convince nurse/midwives of the benefits of membership and thus does not reach its full potential in terms of influencing policy and practice 17.

15 8 Inputs from international and donor agencies According to the World Bank, in Malawi the net Official Development Assistance (ODA) per capita was US$61.5 in 2008, having risen steadily from US$42.0 in Malawi s GDP in 2008 was US$288 per capita, indicating that ODA accounted for approximately 21% of GDP.According to WHO, about 60% of the country s total health expenditure is contributed by development partners 31. The World Bank 32 lists Malawi s main donors as: DFID, EC, World Bank, African Development Bank, Norway, Germany, USAID, and China. These account for over 90% of Malawi s development assistance. Other donors include the traditional UN institutions (notably UNDP, UNICEF, WHO, and WFP), Global Fund, JICA, ICEIDA, and Ireland.

16 9 Main challenges By any objective measure, Malawi suffers from a severe shortage of maternity care professionals, due to a number of issues, including: a low proportion of young people completing secondary education, the practice of girls marrying young, a shortage of nursing/midwifery tutors, midwifery not being a separate profession from nursing, short life expectancy resulting in high levels of death in service and brain drain. Steps have been taken to address many of these issues by the Malawian government and development partners, but much more needs to be done. The HR shortage means that the working conditions of the existing maternity care professionals are poor, which creates a vicious circle in terms of the difficulty of staff retention and also in terms of the number of experienced practitioners available to support and supervise those who have recently qualified. The shortage is particularly marked in rural areas. In common with many developing countries, the vast majority of maternity care professionals are based in urban areas, whereas in Malawi the vast majority of the population lives in rural areas. This means that most Malawian women do not have easy access to trained maternity care professionals. It also means that the provision of support and supervision to the small number of rural practitioners is a major challenge. A shortage of qualified tutors means that, as well as concern about insufficient maternity care professionals being trained, there is concern over class sizes and therefore the quality of the education and training being received. High workloads caused by staff shortages will also make it difficult for qualified practitioners to take part in continuing education and training in order to further their careers and ensure that the care they are providing is of the highest quality. Malawi is a high-fertility country, and current projections predict that the number of births per year will continue to rise until at least Projections of the number of health professionals with midwifery skills needed in Malawi must take into account that most of the population lives in rural areas (which limits the size of the geographical area that each midwife can cover) and that there is a high TFR. Population-based methods of working out the required number of midwives will therefore underestimate the number needed in Malawi. Furthermore, the shortage of qualified physicians is even more severe than the shortage of nurse/midwives, which means that,in addition to their normal duties, nurse/midwives can be expected to perform functions that would normally be performed by doctors. Unless and until the shortage of doctors can be addressed, therefore, the required number of professionals with midwifery skills will be higher than would be the case in a country with adequate physician cover.

17 10 Bibliography and references 1 Malawi Demographic and Health Survey 2004 [12 April 2011]; Available from: 2 Population Reference Bureau.2010 World Population Data Sheet [12 April 2011]; Available from: 3 Population Reference Bureau.2006 World Population Data Sheet [12 April 2011]; Available from: 4 World Health Organisation. Malawi Statistics [12 April 2011]; Available from: 5 UNICEF. Malawi Statistics [12 April 2011]; Available from: 6 Pearson M. Impact Evaluation of the Sector-Wide Approach (SWAp), Malawi: Final report [12 April 2011]; Available from: 7 Republic of Malawi Ministry of Finance.Budget Statement for [12 April 2011]; Available from: 8 Malawi National Statistics Office.Welfare Monitoring Survey [12 April 2011]; Available from: %20%2015th%20%20JULY% pdf. 9 Republic of Malawi Ministry of Health. Road Map for accelerating the reduction of Maternal and Neonatal Mortality and Morbidity in Malawi: Third Revised Version [12 April 2011]; Available from: 10 UNFPA. The State of the World s Midwifery 2011: Delivering Health, Saving Lives. Final Report. June Kamwendo LA. Focus on nurse midwives. Journal of Nursing Scholarship. 1999;31(3): debernis L, Wolman Y. Maternal and Newborn Health National Plans (Road Map) Assessment: African MNH Road Maps Assessment Report [12 April 2011]; Available from: 13 Africa Health Workforce Observatory. Human Resources for Health Country Profile: Malawi [12 April 2011]; Available from: 14 Bisika T. The Effectiveness of the TBA Programme in Reducing Maternal Mortality and Morbidity in Malawi. East African Journal of Public Health 2008;5(2): Kafulafula UK, Hami M, Chodzaza E. The challenges facing nurse-midwives in working towards Safe Motherhood in Malawi.Malawi Medical Journal. 2005;17(4): Kamwendo LA. Childbirth experiences in Malawi. In: Selin H, editor. Childbirth Across Cultures. New York: Springer; Mackintosh LS. A study identifying factors affecting retention of midwives in Malawi: MCommH dissertation. Liverpool School of Tropical Medicine; Muula AS, Mfutso-Bengo JM, Makosa J, Chatipwa E. The Ethics of Developed Nations Recruiting Nurses from Developing Countries: The Case of Malawi. Nursing Ethics. 2003;10(4):433-8.

18 19 World Health Organisation. Working Together for Health: World Health Report [12 April 2011]; Available from: 20 UNFPA. UNFPA Maternal Mortality Update Expectation and Delivery: Investing in Midwives and Others with Midwifery Skills [12 April 2011]; Available from: _eng.pdf. 21 National Statistical Office of Malawi.Demographic and Social Indicators [31 March 2011]; Available from: 22 World Health Organisation. World Health Report 2005: Make Every Mother and Child Count [12 April 2011]; Available from: 23 Kamuzu College of Nursing.Bachelor of Science in Nursing (General) [12 April 2011]; Available from: 24 Caffrey M, Frelick G. Attracting and Retaining Nurse Tutors in Malawi [12 April 2011]; Available from: 25 Muula AS, Nyasulu Y, Msiska G. Gender distribution of teaching staff and students at the Kamuzu College of Nursing, Malawi African Journal of Health Sciences. 2004;11(1-2): World Health Organisation. Malawi Nursing and Midwifery Council works with MPS to develop best standards of practice [12 April 2011]; Available from: 27 Nursing and Midwives Council Malawi. The Mission Statement [12 April 2011); Available from: 28 Ratsma YEC, Mackintosh LS.Skilled attendance at birth.malawi Medical Journal. 2005;17(2): Lipato K. The Association of Malawian Midwives (AMAMI): Advocating for Mothers, Neonates, Families and Midwives [12 April 2011]; Available from: 30 The World Bank. Data by country: Malawi [12 April 2011]; Available from: 31 World Health Organisation. Country Cooperation Strategy At A Glance: Malawi [12 April 2011]; Available from: 32 The World Bank. Malawi: Country Brief [12 April 2011]; Available from: menupk:355882~pagepk:141132~pipk:141107~thesitepk:355870,00.html.

Impact Evaluation Design for Community Midwife Technicians in Malawi

Impact Evaluation Design for Community Midwife Technicians in Malawi Impact Evaluation Design for Community Midwife Technicians in Malawi Nathan B.W. Chimbatata, ( Msc. Epi, BscN, Dip Opth), Mzuzu University, Mzuzu, Malawi Chikondi M. Chimbatata, (BscN, pgucm) Kamuzu College

More information

Evidence Based Practice: Strengthening Maternal and Newborn Health

Evidence Based Practice: Strengthening Maternal and Newborn Health Evidence Based Practice: Strengthening Maternal and Newborn Health Address Mauakowa Malata PhD RNM FAAN Kamuzu College of Nursing International Confederation of Midwives 1 University of Malawi Kamuzu College

More information

Strengthening Midwifery Education and Practice in Post-conflict Liberia. Nancy Taylor Moses ICM Triennial Congress Prague, Czech Republic June 2014

Strengthening Midwifery Education and Practice in Post-conflict Liberia. Nancy Taylor Moses ICM Triennial Congress Prague, Czech Republic June 2014 Strengthening Midwifery Education and Practice in Post-conflict Liberia Nancy Taylor Moses ICM Triennial Congress Prague, Czech Republic June 2014 Objectives Describe strengthening midwifery education

More information

Minister. Secretaries of State. Department of Planning and Health Information. Department of Human Resources Development

Minister. Secretaries of State. Department of Planning and Health Information. Department of Human Resources Development KINGDOM OF CAMBODIA NATION RELIGION KING 1 Minister Secretaries of State Cabinet Under Secretaries of State Directorate General for Admin. & Finance Directorate General for Health Directorate General for

More information

A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH

A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH EXECUTIVE SUMMARY THE STATE OF THE WORLD S MIDWIFERY 2014 A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH REPRODUCTIVE HEALTH PREGNANCY CHILDBIRTH POSTNATAL Executive Summary The State of the World s Midwifery

More information

Global Health Workforce Crisis. Key messages

Global Health Workforce Crisis. Key messages Global Health Workforce Crisis Key messages - 2013 Despite the increased evidence that health workers are fundamental for ensuring equitable access to health services and achieving universal health coverage,

More information

International confederation of Midwives

International confederation of Midwives International confederation of Midwives Traditional Midwife The Palestinian Dayah 1 Midwifery Matters 2011 Issue 131 Page 17 2 In Education In Practice In Research In Profession New trends in midwifery

More information

A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH

A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH FAST FACTS THE STATE OF THE WORLD S MIDWIFERY 2014 A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH REPRODUCTIVE HEALTH PREGNANCY CHILDBIRTH POSTNATAL STATE OF THE WORLD S MIDWIFERY CHALLENGES The 73 countries

More information

Getting it Done for Maternal and Newborn Health. Innovations in Health Systems Strengthening

Getting it Done for Maternal and Newborn Health. Innovations in Health Systems Strengthening The UN Secretary General s Global Strategy for Women s and Children s Health: Getting it Done for Maternal and Newborn Health Innovations in Health Systems Strengthening Pat Riley, CNM, MPH, FACNM Nagesh

More information

Brief ADVOCACY APPROACHES TO PROMOTE MIDWIVES AND THE PROFESSION OF MIDWIFERY. September 2013

Brief ADVOCACY APPROACHES TO PROMOTE MIDWIVES AND THE PROFESSION OF MIDWIFERY. September 2013 September 2013 ADVOCACY APPROACHES TO PROMOTE MIDWIVES AND THE PROFESSION OF MIDWIFERY Brief Tamara Windau-Melmer, White Ribbon Alliance Photo credit: White Ribbon Alliance Midwives play a crucial role

More information

Health and Nutrition Public Investment Programme

Health and Nutrition Public Investment Programme Government of Afghanistan Health and Nutrition Public Investment Programme Submission for the SY 1383-1385 National Development Budget. Ministry of Health Submitted to MoF January 22, 2004 PIP Health and

More information

RCN Response to European Commission Issues Paper The EU Role in Global Health

RCN Response to European Commission Issues Paper The EU Role in Global Health ` RCN INTERNATIONAL DEPARTMENT RCN Response to European Commission Issues Paper The EU Role in Global Health About the Royal College of Nursing UK With a membership of over 400,000 registered nurses, midwives,

More information

Health Workforce Innovative Approaches and Promising Practices Study. Attracting and Retaining Nurse Tutors in Malawi. March 2006

Health Workforce Innovative Approaches and Promising Practices Study. Attracting and Retaining Nurse Tutors in Malawi. March 2006 Health Workforce Innovative Approaches and Promising Practices Study Attracting and Retaining Nurse Tutors in Malawi March 2006 Consultants Margaret Caffrey Graeme Frelick Capacity Project USAID Global

More information

LESOTHO NURSING AND MIDWIFERY STRATEGIC PLAN PRESENTATION BY; MPOEETSI MAKAU, HEAD CLINICAL NURSING SERVICES (MOH-LESOTHO)

LESOTHO NURSING AND MIDWIFERY STRATEGIC PLAN PRESENTATION BY; MPOEETSI MAKAU, HEAD CLINICAL NURSING SERVICES (MOH-LESOTHO) LESOTHO NURSING AND MIDWIFERY STRATEGIC PLAN PRESENTATION BY; MPOEETSI MAKAU, HEAD CLINICAL NURSING SERVICES (MOH-LESOTHO) LESOTHO HEALTH INDICATORS HEALTH INDICATOR RATE TOTAL POPULATION 1,876,633 AVARAGE

More information

INTERPROFESSIONAL EDUCATION CASE STUDY. Resources. for Health Observer. Human

INTERPROFESSIONAL EDUCATION CASE STUDY. Resources. for Health Observer. Human Human Resources for Health Observer Issue n o 14 INTERPROFESSIONAL EDUCATION CASE STUDY Master of Science degree programme in Reproductive Health at Kamuzu College of Nursing, Malawi WHO Library Cataloguing-in-Publication

More information

UHC. Moving toward. Sudan NATIONAL INITIATIVES, KEY CHALLENGES, AND THE ROLE OF COLLABORATIVE ACTIVITIES. Public Disclosure Authorized

UHC. Moving toward. Sudan NATIONAL INITIATIVES, KEY CHALLENGES, AND THE ROLE OF COLLABORATIVE ACTIVITIES. Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Moving toward UHC Sudan NATIONAL INITIATIVES, KEY CHALLENGES, AND THE ROLE OF COLLABORATIVE ACTIVITIES re Authorized Public Disclosure Authorized

More information

Media Kit. August 2016

Media Kit. August 2016 Media Kit August 2016 Please contact External Communications and Media Advisor, Ali Jones on 027 247 3112 / ali@alijonespr.co.nz Or Maria Scott, The College Communications Advisor on 03 372 9744 / 021

More information

Licensed Nurses in Florida: Trends and Longitudinal Analysis

Licensed Nurses in Florida: Trends and Longitudinal Analysis Licensed Nurses in Florida: 2007-2009 Trends and Longitudinal Analysis March 2009 Addressing Nurse Workforce Issues for the Health of Florida www.flcenterfornursing.org March 2009 2007-2009 Licensure Trends

More information

REVIEW ARTICLE Human Resource Requirement Under the Context of Universal Health Coverage (UHC) in Bangladesh: Current Situation and Future Challenges

REVIEW ARTICLE Human Resource Requirement Under the Context of Universal Health Coverage (UHC) in Bangladesh: Current Situation and Future Challenges REVIEW ARTICLE Human Resource Requirement Under the Context of Universal Health Coverage (UHC) in Bangladesh: Current Situation and Future Challenges *MHK Talukder 1, MM Rahman 2, M Nuruzzaman 3 1 Professor

More information

Mr SENESIE MARGAO. The challenge for nurses and midwives of a government free health care initiative

Mr SENESIE MARGAO. The challenge for nurses and midwives of a government free health care initiative Inaugural Commonwealth Nurses Conference Our health: our common wealth 10-11 March 2012 London UK Mr SENESIE MARGAO The challenge for nurses and midwives of a government free health care initiative In

More information

WORLD HEALTH ORGANIZATION. Strengthening nursing and midwifery

WORLD HEALTH ORGANIZATION. Strengthening nursing and midwifery WORLD HEALTH ORGANIZATION FIFTY-SIXTH WORLD HEALTH ASSEMBLY A56/19 Provisional agenda item 14.11 2 April 2003 Strengthening nursing and midwifery Report by the Secretariat 1. The Millennium Development

More information

A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH

A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH EXECUTIVE SUMMARY THE STATE OF THE WORLD S MIDWIFERY 214 A UNIVERSAL PATHWAY. A WOMAN S RIGHT TO HEALTH REPRODUCTIVE HEALTH PREGNANCY CHILDBIRTH POSTNATAL Executive Summary The State of the World s Midwifery

More information

Saving Every Woman, Every Newborn and Every Child

Saving Every Woman, Every Newborn and Every Child Saving Every Woman, Every Newborn and Every Child World Vision s role World Vision is a global Christian relief, development and advocacy organization dedicated to improving the health, education and protection

More information

SCOTT COLLEGE OF NURSING

SCOTT COLLEGE OF NURSING PROSPECTUS SCOTT COLLEGE OF NURSING 2014-2018 LIGHTING THE SPARK OF LEARNING TABLE OF CONTENTS PAGE 1. WELCOME 1 2. VISION 1 3. MISSION STATEMENT 1 4. PROGRAMMES OFFERED 1 5. HOW TO APPLY 2 6. DESCRIPTION

More information

Information for Midwives in relation to the Midwifery Scope of Practice Further interpretation, March 2005

Information for Midwives in relation to the Midwifery Scope of Practice Further interpretation, March 2005 Information for Midwives in relation to the Midwifery Scope of Practice Further interpretation, March 2005 March 2005 Although the Midwifery Council provided information in October 2004 about midwives

More information

INDONESIA S COUNTRY REPORT

INDONESIA S COUNTRY REPORT The 4 th ASEAN & Japan High Level Officials Meeting on Caring Societies: Support to Vulnerable People in Welfare and Medical Services Collaboration of Social Welfare and Health Services, and Development

More information

Period of June 2008 June 2011 Partner Country s Implementing Organization: Federal Cooperation

Period of June 2008 June 2011 Partner Country s Implementing Organization: Federal Cooperation Summary of Terminal Evaluation Results 1. Outline of the Project Country: Sudan Project title: Frontline Maternal and Child Health Empowerment Project (Mother Nile Project) Issue/Sector: Maternal and Child

More information

Presentation for CHA Meeting in Bagamoyo on By Patricia Schwerzel, Public Health Advisor, ETC Crystal.

Presentation for CHA Meeting in Bagamoyo on By Patricia Schwerzel, Public Health Advisor, ETC Crystal. DEVELOPMENT OF A FRAMEWORK FOR THE DEVELOPMENT OF A BENEFIT/,MOTIVATION PACKAGE FOR RURAL HEALTH WORKERS IN VOLUNTARY AGENCIES (VA) OWNED HOSPITALS BASED ON FINDINGS IN THE LAKE ZONE Presentation for CHA

More information

The Health Sector in Uganda and the Work of CUAMM. Dr. Peter Lochoro Country Representative Doctors with Africa CUAMM Uganda

The Health Sector in Uganda and the Work of CUAMM. Dr. Peter Lochoro Country Representative Doctors with Africa CUAMM Uganda The Health Sector in Uganda and the Work of CUAMM Dr. Peter Lochoro Country Representative Doctors with Africa CUAMM Uganda 1 2 General issues Democratic government, stable country and more peaceful Population

More information

SKILLED CARE DURING CHILDBIRTH

SKILLED CARE DURING CHILDBIRTH SKILLED CARE DURING CHILDBIRTH COUNTRY PROFILES >> TUNISIA SRI LANKA MALAYSIA BOTSWANA >> Saving Women s Lives, Improving Newborn Health >> Skilled Care During Childbirth: Country Profiles Table of Contents

More information

THE STATE OF ERITREA. Ministry of Health Non-Communicable Diseases Policy

THE STATE OF ERITREA. Ministry of Health Non-Communicable Diseases Policy THE STATE OF ERITREA Ministry of Health Non-Communicable Diseases Policy TABLE OF CONTENT Table of Content... 2 List of Acronyms... 3 Forward... 4 Introduction... 5 Background: Issues and Challenges...

More information

COLLEGE OF MIDWIVES OF BRITISH COLUMBIA

COLLEGE OF MIDWIVES OF BRITISH COLUMBIA COLLEGE OF MIDWIVES OF BRITISH COLUMBIA DEFINITION OF A MIDWIFE MIDWIFERY MODEL OF PRACTICE A midwife is a person who, having been regularly admitted to a midwifery educational programme duly recognised

More information

Regional Strategy for Nursing and Midwifery in the Eastern Mediterranean Region

Regional Strategy for Nursing and Midwifery in the Eastern Mediterranean Region Regional Strategy for Nursing and Midwifery in the Eastern Mediterranean Region - Introduction Nurses and midwives increasingly face rising levels of complexity in health care, coupled with expanding scopes

More information

#HealthForAll ichc2017.org

#HealthForAll ichc2017.org #HealthForAll ichc2017.org 1 Positioning CHW s within HRH Strategies: Key Issues and Opportunities Liberia Case Study Ochiawunma Ibe, MD, MPH, Msc (MCH), FWACP Background Outline Demographic profile and

More information

Standards for competence for registered midwives

Standards for competence for registered midwives Standards for competence for registered midwives The Nursing and Midwifery Council (NMC) is the nursing and midwifery regulator for England, Wales, Scotland and Northern Ireland. We exist to protect the

More information

Mr MARAKA MONAPHATHI. Nurses views on improving midwifery practice in Lesotho

Mr MARAKA MONAPHATHI. Nurses views on improving midwifery practice in Lesotho Inaugural Commonwealth Nurses Conference Our health: our common wealth 10-11 March 2012 London UK Mr MARAKA MONAPHATHI Nurses views on improving midwifery practice in Lesotho In collaboration with the

More information

Tehran University of Medical Sciences. School of Nursing and Midwifery. Midwifery. (General specifications, plans and headlines)

Tehran University of Medical Sciences. School of Nursing and Midwifery. Midwifery. (General specifications, plans and headlines) Tehran University of Medical Sciences School of Nursing and Midwifery Midwifery (General specifications, plans and headlines) Final revision and editing 2016 Section I: Title: Midwifery (BSc) Degree: BSc

More information

FANTA III. Improving Pre-Service Nutrition Education and Training of Frontline Health Care Providers TECHNICAL BRIEF

FANTA III. Improving Pre-Service Nutrition Education and Training of Frontline Health Care Providers TECHNICAL BRIEF TECHNICAL BRIEF Food and Nutrition Technical Assistance III Project June 2018 Improving Pre-Service Nutrition Education and Training of Frontline Health Care Providers Introduction The purpose of this

More information

Report on District Nurse Education in England, Wales and Northern Ireland 2012/13

Report on District Nurse Education in England, Wales and Northern Ireland 2012/13 Report on District Nurse Education in England, Wales and Northern Ireland 2012/13 Introduction The QNI has become concerned at recent reports of a fall in the number of District Nurses currently in training

More information

JICA Thematic Guidelines on Nursing Education (Overview)

JICA Thematic Guidelines on Nursing Education (Overview) JICA Thematic Guidelines on Nursing Education (Overview) November 2005 Japan International Cooperation Agency Overview 1. Overview of nursing education 1-1 Present situation of the nursing field and nursing

More information

Situation Analysis Tool

Situation Analysis Tool Situation Analysis Tool Developed by the Programme for Improving Mental Health CarE PRogramme for Improving Mental health care (PRIME) is a Research Programme Consortium (RPC) led by the Centre for Public

More information

AUSTRALIA S FUTURE HEALTH WORKFORCE Nurses Detailed Report

AUSTRALIA S FUTURE HEALTH WORKFORCE Nurses Detailed Report AUSTRALIA S FUTURE HEALTH WORKFORCE Nurses Detailed Report August 2014 Commonwealth of Australia 2014 This work is copyright. You may download, display, print and reproduce the whole or part of this work

More information

Catherine Hughson Kathryn Kearney Number of supervisors relinquishing role since last report:

Catherine Hughson Kathryn Kearney Number of supervisors relinquishing role since last report: Name of Local Supervising Authority: Western Isles Health Board Period of report: 2005/2006 Date: September 2006 1. Supervision of Midwives and Midwifery Practice 1.1 Designated Local Supervising Authority

More information

Democratic Republic of Congo

Democratic Republic of Congo World Health Organization Project Proposal Democratic Republic of Congo OVERVIEW Target country: Democratic Republic of Congo Beneficiary population: 8 million (population affected by the humanitarian

More information

NURSING AND MIDWIFERY IN AFRICA

NURSING AND MIDWIFERY IN AFRICA NURSING AND MIDWIFERY IN AFRICA The process of review and reform of legislation Genevieve Howse, Legal Adviser Introduction Thinking about a review Analyse the environment Legal and Policy environment

More information

Chapter 6 Planning for Comprehensive RH Services

Chapter 6 Planning for Comprehensive RH Services Chapter 6 Planning for Comprehensive RH Services This section outlines the steps to take to be ready to expand RH services when all the components of the MISP have been implemented. It is important to

More information

USAID/Philippines Health Project

USAID/Philippines Health Project USAID/Philippines Health Project 2017-2021 Redacted Concept Paper As of January 24, 2017 A. Introduction This Concept Paper is a key step in the process for designing a sector-wide USAID/Philippines Project

More information

CURRICULUM: BACHELOR OF MIDWIFERY (B.M) Table of Contents

CURRICULUM: BACHELOR OF MIDWIFERY (B.M) Table of Contents CURRICULUM: BACHELOR OF MIDWIFERY (B.M) January 2009 Table of Contents Preamble 1: Aims of the degree programme in Midwifery 2: A profile of the degree programme in Midwifery 2.1 The professional activity

More information

Cambodia: Reproductive Health Care

Cambodia: Reproductive Health Care Cambodia: Reproductive Health Care Ex post evaluation report OECD sector BMZ project ID 2002 66 619 Project executing agency Consultant Year of ex-post evaluation report 13020/Reproductive health care

More information

The Prospect of Skilled Community Paramedics in the Healthcare Sector

The Prospect of Skilled Community Paramedics in the Healthcare Sector The Prospect of Skilled Community Paramedics in the Healthcare Sector A roundtable discussion on The prospect of skilled community paramedics in the health sector was organised by Daily Prothom Alo on

More information

Cesarean section safety and quality: The surgical, anesthesia and obstetric (SAO) workforce

Cesarean section safety and quality: The surgical, anesthesia and obstetric (SAO) workforce Cesarean section safety and quality: The surgical, anesthesia and obstetric (SAO) workforce Lina Roa, MD Paul Farmer Research Fellow in Global Surgery and Social Change (PGSSC), Harvard Medical School

More information

INTERNATIONAL ASSOCIATION FOR NATIONAL YOUTH SERVICE

INTERNATIONAL ASSOCIATION FOR NATIONAL YOUTH SERVICE Profile verified by: Mr. Vincent Senam Kuagbenu Executive Director of the Ghana National Service Scheme Date of Receipt: 12/04/2012 Country: Ghana INTRODUCTION: The Ghana National Service Scheme is a public

More information

Standards for pre-registration nursing programmes

Standards for pre-registration nursing programmes Part 3: Programme standards Standards for pre-registration nursing programmes Introduction Our Standards for pre-registration nursing programmes set out the legal requirements, entry requirements, availability

More information

Southern African Network of Nurses And Midwives (SANNAM) Experiences in Networking CNF Malta 30 April, 2011 Nyangi Philemon Ngomu

Southern African Network of Nurses And Midwives (SANNAM) Experiences in Networking CNF Malta 30 April, 2011 Nyangi Philemon Ngomu Southern African Network of Nurses And Midwives (SANNAM) Experiences in Networking CNF Malta 30 April, 2011 Nyangi Philemon Ngomu SANNAM Background Known as: SADC AIDS Network of Nurses and Midwives The

More information

A TOOLKIT FOR USING EVIDENCE FROM THE

A TOOLKIT FOR USING EVIDENCE FROM THE Making the Case for Midwifery: A TOOLKIT FOR USING EVIDENCE FROM THE STATE OF THE WORLD S MIDWIFERY 2014 REPORT TO CREATE POLICY CHANGE AT THE COUNTRY LEVEL Available for download in English, French and

More information

Egypt, Arab Rep. - Demographic and Health Survey 2008

Egypt, Arab Rep. - Demographic and Health Survey 2008 Microdata Library Egypt, Arab Rep. - Demographic and Health Survey 2008 Ministry of Health (MOH) and implemented by El-Zanaty and Associates Report generated on: June 16, 2017 Visit our data catalog at:

More information

Example only - not for general use

Example only - not for general use International Registration: Form to Accompany Transcript of Training International Registrations Dept, 23 Portland Place, London, W1B 1PZ Phone: +44 207333 9333 Web: www.nmc-uk.org To the applicant: Please

More information

Running head: PUBLIC HEALTH IN MALAWI 1. The Potential Impact of a Master s Degree in Community/Public Health Nursing

Running head: PUBLIC HEALTH IN MALAWI 1. The Potential Impact of a Master s Degree in Community/Public Health Nursing Running head: PUBLIC HEALTH IN MALAWI 1 The Potential Impact of a Master s Degree in Community/Public Health Nursing on Public Health Issues in Malawi By Kelly A. Johnson A Master s Paper submitted to

More information

CICIAMS. United Nations Non Governmental Organization (NGO)

CICIAMS. United Nations Non Governmental Organization (NGO) United Nations Non Governmental Organization (NGO) The Nurse s Role Related to Fertility Health, the Aging Population, & Replacement Population United Nations Non Governmental Organization (NGO) Thank

More information

Defining competent maternal and newborn health professionals

Defining competent maternal and newborn health professionals Prepared for WHO Executive Board, January 2018. This is a pre-publication version and not intended for quotation or citation. Please contact the Secretariat with any queries, by email to: reproductivehealth@who.int

More information

Case Study HEUTOWN DISTRICT: PLANNING AND RESOURCE ALLOCATION

Case Study HEUTOWN DISTRICT: PLANNING AND RESOURCE ALLOCATION Case Study HEUTOWN DISTRICT: PLANNING AND RESOURCE ALLOCATION Di McIntyre Health Economics Unit, University of Cape Town, Cape Town, South Africa This case study may be copied and used in any formal academic

More information

A review of policy in South Asia and Sub Saharan Africa

A review of policy in South Asia and Sub Saharan Africa Public Disclosure Authorized Public Disclosure Authorized Human Resources for Maternal and Neonatal Health: A review of policy in South Asia and Sub Saharan Africa Public Disclosure Authorized Prepared

More information

FINDING SOLUTIONS. for Women?s and Girls?Health and Education in Afghanistan

FINDING SOLUTIONS. for Women?s and Girls?Health and Education in Afghanistan FINDING SOLUTIONS for Women?s and Girls?Health and Education in Afghanistan 2016 A metaanalysis of 10 projects implemented by World Vision between 20072015 in Western Afghanistan 2 BACKGROUND Afghanistan

More information

2.1 Communicable and noncommunicable diseases, health risk factors and transition

2.1 Communicable and noncommunicable diseases, health risk factors and transition 1. CONTEXT 1.1 Demographics In 2010, American Samoa had an estimated population of 65 896. Based on 2010 population estimates, around 35% of the population is below 15 years of age, while 4% is above 65

More information

CHAPTER 30 HEALTH AND FAMILY WELFARE

CHAPTER 30 HEALTH AND FAMILY WELFARE CHAPTER 30 HEALTH AND FAMILY WELFARE The health of the population is a matter of serious national concern. It is highly correlated with the overall development of the country. An efficient Health Information

More information

The Nurse Labor and Education Markets in the English-Speaking CARICOM: Issues and Options for Reform

The Nurse Labor and Education Markets in the English-Speaking CARICOM: Issues and Options for Reform A. EXECUTIVE SUMMARY 1. The present report concludes the second phase of the cooperation between CARICOM countries and the World Bank to build skills for a competitive regional economy. It focuses on the

More information

To enable you to prepare a proposal for this assignment, please find attached the following documents:

To enable you to prepare a proposal for this assignment, please find attached the following documents: Call for Proposals Date: 17 January 2018 Request to submit a written technical and financial proposal for an assignment with STEP on: Bursary Program for Non-formal Skills Development Training Program

More information

COMPETENCE ASSESSMENT TOOL FOR MIDWIVES

COMPETENCE ASSESSMENT TOOL FOR MIDWIVES Nursing and Midwifery Board of Ireland (NMBI) COMPETENCE ASSESSMENT TOOL FOR MIDWIVES 1 The has been developed for midwives educated and trained outside Ireland who do not qualify for registration under

More information

Midwifery Standard Setting and Regulation: Successes and Challenges

Midwifery Standard Setting and Regulation: Successes and Challenges The African Regulatory Collaborative (ARC): Strengthening Nursing and Midwifery Regulation and Practice in Africa February 28-March 2, 2011 Midwifery Standard Setting and Regulation: Successes and Challenges

More information

INTRODUCTION. 76 MCHIP End-of-Project Report. (accessed May 8, 2014).

INTRODUCTION. 76 MCHIP End-of-Project Report. (accessed May 8, 2014). Redacted INTRODUCTION Between 1990 and 2012, India s mortality rate in children less than five years of age declined by more than half (from 126 to 56/1,000 live births). The infant mortality rate also

More information

British Medical Association National survey of GPs The future of General Practice 2015

British Medical Association National survey of GPs The future of General Practice 2015 British Medical Association National survey of GPs The future of General Practice 2015 Extract of Findings December February 2015 A report by ICM on behalf of the BMA Creston House, 10 Great Pulteney Street,

More information

Core Domain You will be able to: You will know and understand: Leadership, Management and Team Working

Core Domain You will be able to: You will know and understand: Leadership, Management and Team Working DEGREE APPRENTICESHIP - REGISTERED NURSE 1 ST0293/01 Occupational Profile: A career in nursing is dynamic and exciting with opportunities to work in a range of different roles as a Registered Nurse. Your

More information

The USAID portfolio in Health, Population and Nutrition (HPN)

The USAID portfolio in Health, Population and Nutrition (HPN) The USAID portfolio in Health, Population and Nutrition (HPN) Goal: Promote and improve health and well-being of Malawians through investing in sustainable, high-impact health initiatives in line with

More information

BOOKLET FOR NURSE MIDWIFE EDUCATORS & NURSE MIDWIFE CLINICIANS ON HOW TO IMPROVE THE TEACHING-LEARNING & WORKING ENVIRONMENT FOR MALE NURSE MIDWIVES

BOOKLET FOR NURSE MIDWIFE EDUCATORS & NURSE MIDWIFE CLINICIANS ON HOW TO IMPROVE THE TEACHING-LEARNING & WORKING ENVIRONMENT FOR MALE NURSE MIDWIVES BOOKLET FOR NURSE MIDWIFE EDUCATORS & NURSE MIDWIFE CLINICIANS ON HOW TO IMPROVE THE TEACHING-LEARNING & WORKING ENVIRONMENT FOR MALE NURSE MIDWIVES M.M CHINKHATA BOOKLET FOR NURSE MIDWIFE EDUCATORS &

More information

Strengthening nursing and midwifery in the Eastern Mediterranean Region

Strengthening nursing and midwifery in the Eastern Mediterranean Region WHO-EM/NUR/429/E Strengthening nursing and midwifery in the Eastern Mediterranean Region A framework for action 2016-2025 Strengthening nursing and midwifery in the Eastern Mediterranean Region A framework

More information

National Report Hungary 2008

National Report Hungary 2008 National Report Hungary 2008 Policies Last year the Hungarian Defence Forces (HDF) were renewed in their structure completing a long lasting military reform procedure, which was accelerated by the latest

More information

Communicating Research Findings to Policymakers

Communicating Research Findings to Policymakers Communicating Research Findings to Policymakers Increasing the Chances of Success Satellite Session: Strengthening Research on Policy Implementation and Why it Matters to Health Outcomes Suneeta Sharma,

More information

MALAWI. COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment*, Dar-es-Salaam, Tanzania, February 13-15, 2012

MALAWI. COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment*, Dar-es-Salaam, Tanzania, February 13-15, 2012 COUNTRY ACCOUNTABILITY FRAMEWORK: Assessment*, Dar-es-Salaam, Tanzania, February 13-15, 2012 Policy Context Global strategy on women and children/ commitment National Health policy/national Health Plan/Strategies

More information

Health Foundation submission: Health Select Committee inquiry on nursing workforce

Health Foundation submission: Health Select Committee inquiry on nursing workforce Health Foundation submission: Health Select Committee inquiry on nursing workforce October 2017 Thank you for the opportunity to respond to the Health Select Committee inquiry on nursing workforce. Our

More information

AFGHANISTAN HEALTH, DISASTER PREPAREDNESS AND RESPONSE. CHF 7,993,000 2,240,000 beneficiaries. Programme no 01.29/99. The Context

AFGHANISTAN HEALTH, DISASTER PREPAREDNESS AND RESPONSE. CHF 7,993,000 2,240,000 beneficiaries. Programme no 01.29/99. The Context AFGHANISTAN HEALTH, DISASTER PREPAREDNESS AND RESPONSE CHF 7,993,000 2,240,000 beneficiaries Programme no 01.29/99 The Context Twenty years of conflict in Afghanistan have brought a constant deterioration

More information

Myanmar Health Forum 2015

Myanmar Health Forum 2015 Myanmar Health Forum 2015 Development of Human Resources for Health to attain UHC Tin Tun Director (HRH Management) Department of Health Professional Resource Development and Management, Ministry of Health

More information

Indian Healthcare System: Issues and Challenges

Indian Healthcare System: Issues and Challenges Indian Healthcare System: Issues and Challenges Dr. Bimal Jaiswal1, Ms. Noor Us Saba1 1Department of Applied Economics, Faculty of Commerce, University of Lucknow, Lucknow, U.P. 2Visiting Faculty, Institute

More information

Submission to the Productivity Commission Issues Paper

Submission to the Productivity Commission Issues Paper Submission to the Productivity Commission Issues Paper Vocational Education and Training Workforce July 2010 LEE THOMAS Federal Secretary YVONNE CHAPERON Assistant Federal Secretary Australian Nursing

More information

Recruitment and Placement of Foreign Health Care Professionals to Work in the Public Sector Health Care in South Africa: Assessment

Recruitment and Placement of Foreign Health Care Professionals to Work in the Public Sector Health Care in South Africa: Assessment Recruitment and Placement of Foreign Health Care Professionals to Work in the Public Sector Health Care in South Africa: Assessment International Organization for Migration (IOM) Regional Office for Southern

More information

The World Breastfeeding Trends Initiative (WBTi)

The World Breastfeeding Trends Initiative (WBTi) The World Breastfeeding Trends Initiative (WBTi) MALAWI ASSESSMENT REPORT MINISTRY OF HEALTH NUTRITION UNIT 1 Acronyms: AIDS BFHI GIMS HIV HTC IBFAN IEC ILO IYCF MDHS M & E MOH MPC MTCT NGO PMTCT UNICEF

More information

Water, sanitation and hygiene in health care facilities in Asia and the Pacific

Water, sanitation and hygiene in health care facilities in Asia and the Pacific Water, sanitation and hygiene in health care facilities in Asia and the Pacific A necessary step to achieving universal health coverage and improving health outcomes This note sets out the crucial role

More information

COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS WHO Country Cooperation Strategy

COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS WHO Country Cooperation Strategy COMMONWEALTH OF THE NORTHERN MARIA ISLANDS WHO Country Cooperation Strategy 2018 2022 OVERVIEW The Commonwealth of the Northern Mariana Islands is one of five inhabited United States island territories.

More information

Magnitude and associated factors of health professionals attrition from public health sectors in Bahir Dar City, Ethiopia *

Magnitude and associated factors of health professionals attrition from public health sectors in Bahir Dar City, Ethiopia * Vol.5, No.11, 1909-1916 (2013) http://dx.doi.org/10.4236/health.2013.511258 Health Magnitude and associated factors of health professionals attrition from public health sectors in Bahir Dar City, Ethiopia

More information

NATIONAL MIDWIFERY CREDENTIALS IN THE UNITED STATES OF AMERICA

NATIONAL MIDWIFERY CREDENTIALS IN THE UNITED STATES OF AMERICA Comparison of Certified Nurse-Midwives, Certified Midwives, Certified Professional Midwives Clarifying the Distinctions Among Professional Midwifery Credentials in the U.S. INTERNATIONAL CONFEDERATION

More information

Health System Analysis for Better. Peter Berman The World Bank Jakarta, Indonesia February 8, 2011 Based on Berman and Bitran forthcoming 2011

Health System Analysis for Better. Peter Berman The World Bank Jakarta, Indonesia February 8, 2011 Based on Berman and Bitran forthcoming 2011 Health System Analysis for Better Health System Strengthening Peter Berman The World Bank Jakarta, Indonesia February 8, 2011 Based on Berman and Bitran forthcoming 2011 Health Systems Analysis: Can be

More information

Sources for Sick Child Care in India

Sources for Sick Child Care in India Sources for Sick Child Care in India Jessica Scranton The private sector is the dominant source of care in India. Understanding if and where sick children are taken for care is critical to improve case

More information

REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL. Report on the interim evaluation of the «Daphne III Programme »

REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL. Report on the interim evaluation of the «Daphne III Programme » EUROPEAN COMMISSION Brussels, 11.5.2011 COM(2011) 254 final REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL Report on the interim evaluation of the «Daphne III Programme 2007 2013»

More information

Respectful Care in Ethiopia The MCHIP Experience

Respectful Care in Ethiopia The MCHIP Experience Respectful Care in Ethiopia The MCHIP Experience MCHIP/ZIMBABWE Hannah Gibson, Country Director/MCHIP Project, Ethiopia Presentation Overview Country Background The Problem Why are women not going to facilities?

More information

RWANDA S COMMUNITY HEALTH WORKER PROGRAM r

RWANDA S COMMUNITY HEALTH WORKER PROGRAM r RWANDA S COMMUNITY HEALTH WORKER PROGRAM r Summary Background The Rwanda CHW Program was established in 1995, aiming at increasing uptake of essential maternal and child clinical services through education

More information

In , WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives:

In , WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: VANUATU Vanuatu, a Melanesian archipelago of 83 islands and more than 100 languages, has a land mass of 12 189 square kilometres and a population of 234 023 in 2009 (National Census). Vanuatu has a young

More information

Juba College of Nursing and Midwifery, Republic of South Sudan

Juba College of Nursing and Midwifery, Republic of South Sudan Juba College of Nursing and Midwifery, Republic of South Sudan Date: Prepared by: July 31, 2017 Dr. Taban Martin Vitale I. Demographic Information 1. City & State Juba, Central Equatoria State, Republic

More information

Employee Telecommuting Study

Employee Telecommuting Study Employee Telecommuting Study June Prepared For: Valley Metro Valley Metro Employee Telecommuting Study Page i Table of Contents Section: Page #: Executive Summary and Conclusions... iii I. Introduction...

More information

Lilongwe /Johannesburg: Cities Mentorship Program. March 06, December 31, 2012

Lilongwe /Johannesburg: Cities Mentorship Program. March 06, December 31, 2012 22 Lilongwe Title of the Initiative Initiative Duration Submitted by Comments by the Jury Lilongwe /Johannesburg: Cities Mentorship Program March 06, 2008 - December 31, 2012 Mr. Gift Dalitso Kasamira,

More information

SCOPE OF PRACTICE. for Midwives in Australia

SCOPE OF PRACTICE. for Midwives in Australia SCOPE OF PRACTICE for Midwives in Australia 1 1 ST EDITION 2016. Australian College of Midwives. All rights reserved. This material may be freely reproduced for educational and not-for-profit purposes.

More information

Private Midwives Serve the Hard-to-Reach: A Promising Practice Model

Private Midwives Serve the Hard-to-Reach: A Promising Practice Model Private Midwives Serve the Hard-to-Reach: A Promising Practice Model A midwife checks the blood pressure of a patient at the Al-Hayat Medical Clinic in the Governorate of Amran in Yemen. The Extending

More information