Confidence boosted and lives saved thanks to clinical training and mentorship in rural Kapenda Health Center, Chitipa
Malawi has a maternal mortality ratio of 439 deaths per 100,000 live births, which makes it one of the poorest performing countries in sub-Saharan Africa against this indicator. To address this, the Global Affairs Canada funded Integrated Pathways for Maternal, Newborn and Child Health (InPATH) Project supported Chitipa District with a range of activities with the aim of contributing to the reduction of maternal mortality. One of these activities was the training of service providers in ALARM International Program /Basic Emergency Obstetric and Newborn Care (AIP/BEmONC), starting in November 2017.
Kapenda Health Center is in the north-east of Chitipa District serving a catchment population of 26,613. It only had one Nurse Midwife Technician, a man named Mr. Ken Kanyika. Ken was trained in AIP/BEmONC in December 2017. Despite being trained, Ken still lacked confidence in performing assisted vaginal deliveries (through vacuum extraction method). The Kapenda Health Center seldom receives clients necessitating this type of service; therefore, he had little or no opportunity to practice his skills. Vacuum extraction delivery is one of the key skills taught in the AIP/BEmONC training delivered by InPATH and is commonly practiced service providers around the world.
“To speak the truth, since I came from BEmONC training in Mzuzu in 2017 I have not done any vacuum extraction delivery at this facility, not that the cases are not available but I am just afraid that I may not be successful in performing the procedure, and that the woman may still need to be referred to the district hospital”, he explained.
Recognising the lack of confidence among Nurse Midwife Technicians in certain critical skills, InPATH introduced a clinical mentorship program to provide ongoing support to graduates of the AIP/BEmONC training. The clinical mentorship program was rolled out in health facilities in February 2019, and Ken was quick request a mentor who could assist him with skills in conducting vacuum extraction deliveries. It was in August 2019 when Ken graduated from clinical mentorship, and two months following his graduation, the midwife performed his first vacuum extraction delivery. Since then, Ken has conducted four assisted vaginal deliveries, which has saved the lives of four mothers and four babies who would have otherwise been at risk of injury or death.
About the Integrated Pathways for Improving Maternal, Newborn, and Child Health (InPATH) Project The Integrated Pathways for Improving Maternal, Newborn, and Child Health (InPATH) Project is a four and half year, CAD 25.8 million multi-sectoral programme (2016-2021) funded by Global Affairs Canada, One Drop Foundation and JCM Power and in implemented through a consortium of three partners led by CowaterSogema , Plan Canada and the Society of Obstetricians and Gynaecologists of Canada in close collaboration with Ministry of Health and Population in Malawi. The goal of 2016-2021 InPATH project is to contribute towards the reduction of maternal and child mortality in Kasungu, Chitipa and Salima districts of Malawi. To do so, this project is addressing the capacity gaps of skilled health personnel by building local-level capacity of facility and community-based health workers; the need for safe and hygienic environment for deliveries, antenatal and postnatal care through improved water and sanitation at health facilities; and the involvement of citizens in local-level decision making for MNCH service delivery through strengthened local governance structures and mechanisms for citizen engagement.
