training of midwives in Sierra Leone. The deficiency of midwifery skills in the already trained SECHNs was recognized as a defect of their preparation, hence the decision to retrain them within the shortest possible time to enable them function within the communities as midwife technicians. This will address the inadequate number of midwives in the country and will equally contribute to the reduction of maternal and newborn mortality. This is the right direction toward achieving the Sustainable Development Goals(SDGs) It is envisaged that the graduates of the new MT programme will acquire the competencies needed to improve the maternal and newborn outcomes especially in the primary health care settings. The graduates, who will be regulated by the Nursing and Midwifery Council of Sierra Leone, will be directly supervised by the midwives in various settings. They will be part of a multidisciplinary team who will provide high quality reproductive, maternal and child health (RMNCH) services in the communities. By virtue of their dual training, they can function as part of this team, and could also enjoy the autonomy to practice independently. DEVELOPMENT The new MT curriculum development process was preceded by several meetings involving nurse - midwives leaders brainstorming on the perceived deficiencies of the SECHNs and the poor quality of their output, as expressed by employers and the public. During these stakeholders’ meetings, it was agreed there is need to further prepare the SECHNs in the area of midwifery as Midwife Technicians (MT) so that they could be automatically absorbed into the payroll whilst they are deployed in primary health care settings to provide midwifery services. In order to develop the curriculum, a five day residential workshop was organized and funded by WHO in partnership with the Directorate of Nursing and Midwifery services and the Nursing and Midwifery Council The sessions were mainly facilitated by both international and national consultants. About 25 participants from nursing and midwifery institutions and nurse- midwife leaders contributed to the development of the first draft. Consensus building was achieved through group discussions and plenary. Reference documents used included the School of midwifery, Makeni Curriculum for State Certified Midwives; Malawi Nurse Midwives Technician Curriculum; and the existing SECHN curriculum. An Important aspect integrated into the curriculum is the clinical courses which were designed at the end of the theoretical courses. CURRICULUM
Perform manual removal of the placenta and membranes Perform bimanual compression of the uterus Examine postnatal mother with complications Identify women with complications and initiate appropriate interventions including timely referral Assess uterine contractility and involution Provide perineal care and assess healing of lacerations, tears, and episiotomy Apply infection control measures Applying Kangaroo care Supporting mother to initiate breastfeeding Assist the mother with positioning and attachment of the baby to the breast Immunisation Provide family planning counselling for mothers and companions Provide discharge instructions to HIV-positive mothers and companion Participate in Maternal and Neonatal death audit Document all client care TEACHING/LEARNING METHODS Group discussion; Demonstration/Return demonstration; Case study; role play; clinical conferences; question and answers METHOD OF ASSESSMENT Continuous Assessment 30% - Case studies; Case presentations; individual/group assignments; Clinical Teaching Summative - End of Course examination (Written (70%); Practical - OSCE (100%) RESOURCES Bowen, R. and Taylor, W. (2005). Skills for Midwifery Practice. (2nd Ed.). Philadelphia: Churchill Livingstone. Coad, J. & Dunstall, M. (2005). Anatomy and physiology for midwives. (2nd Ed.). Philadelphia: Churchill Livingstone. Fraser, D. and Cooper, M. (2009). Myles’ Textbook for Midwives. (15th Ed.). Edinburgh: Churchill Livingstone. Fraser, D. M., et al (2008). Myles Textbook for Midwives, African Edition. Edinburgh: Churchill Livingstone PROGRAMME: MIDWIFE TECHNICIAN PROGRAMME