dr. lamia eltigani elfadil mahmoud national reproductive health director federal ministry of health,...
TRANSCRIPT
Dr. Lamia Eltigani Elfadil MahmoudNational Reproductive Health DirectorFederal Ministry of Health, Sudan
Turning a corner on the road to maternal health;
A New Vision for Midwifery in Sudan
Sudan... the largest country on the African Continent...
• MM - 1107/ 100,000 LB; Neonatal 82/1000 LB• Sudan pioneer in midwifery – started in 1921; now
38 midwifery schools • 13,800 village MWs all over the country• Various categories of midwifery cadres• 80.6% of deliveries occur at home• 49% of deliveries attended by trained providers• EmOC coverage 79%, but of questionable quality• Policy- a midwife for every village (deployment)• Non- employment of village midwives
Too many challenges…..
• Village MWs versus SBAs• Only 56.4% of villages covered with VMWs• Poor condition of schools (physical)-
teaching material, schools not functioning at full capacity
• Donor dependance of schools• Tutor competencies (state level)• Untill recently, no standardization of
curricula• Job security & recognition
Window of Opportunity
Timely moment for new initiatives:• Growing global movement to support
midwifery• Government commitment to midwifery• Collaborative national effort and ownership• Academy of Health Sciences & universities• Formulation of the National Midwifery
Association• International midwifery advisor (3 for Sudan)• Launching of Sudan Midwifery Strategy on
the International Day of the Midwife
National Midwifery Strategy; framework for scaling up midwifery
Midwifery services
Supervisionsupport
TrainingEducation Access
equity
Policy, legal regulation
Stewardship
FundingImage
attractiveness
MonitoringEvaluation
Enabling Environment
What have we done?
Adoption of 2 new pathways for midwifery training;
• 4 yrs BSc curriculum, started on 18th October 2009 (national)
• 2 yrs midwifery technician curriculum, piloted in 5 schools (states with highest MM)
• What’s new?– Higher entry educational level– Revised curriculum, aligned to WHO standards for
SBAs– Improved training environment
Lessons learned
• Advocacy, advocacy, advocacy• Inclusion of midwives into the formal
health system is a MUST• Recruiting candidates from remote villages
is a challenge• Availing core teams of competent trainers
in the states• A regulatory framework for midwifery must
be initiated• Supportive supervision to VMWs• Close monitoring of implementation
process
Sudan needs midwives now more than ever….