Improving Pre Service Education Towards Reduction of Maternal and Newborn Mortality in Tanzania

5TH - 7th September 2012 ECSACON Mauritius

Ukende Shalla Pre- service Nursing and Midwifery Advisor

Presentation Outline
Back ground of maternal and newborn mortality in Tanzania Supporting of pre- service education nursing and midwifery Focused Antenatal Care to Nurse tutors BEmONC training to Nurse tutors Improving of Skill lab in Nursing and midwifery schools in Tanzania Communication and malaria Initiative in
Tanzania( COMMIT) in NM schools

Background
Population over 40mill, 75%
residing in rural areas

Total fertility rate 5.7 children

per woman

MMR - 454 deaths/100,000 live births

Tanzania is ranked 9th in number and proportion of maternal deaths and live births for top 21
Health facility delivery- is 51% (TDHS 2010)
1out of 10 women in Tanzania is at risk of dying during pregnancy and childbirth (WHO).

Background information MNH

ANC attendance is 96% 51% do have facility delivery under skilled personnel. Only 6% of facilities has skilled staff trained on newborn resuscitation 13% mothers who had delivered outside the facility do receive postnatal care within 48 hours post delivery.

Tanzania Newborn Situation Analysis

1.6 million babies are born each year in Tanzania 51,000 deaths occur in babies within the first month of life every year Neonatal mortality rate is 26/1,000 live births

MAISHA/Jhpiego Support to Nursing and Midwifery P SE In Tanzania

MAISHA national program funded by USAID lead by Jhpiego is supporting the Nursing Training Unit of HRDD at MOHSW to strengthen Pre-service Nurse/Midwifery Education Areas of support

FANC originate d with integration of into curriculum and training of tutors and clinical preceptors

Train tutors on Basic Emergency Obstetric and Newborn Care (BEmONC) under ACCESS

Supporting on skill lab

OSCE training Skills labs establishment at 25 schools including equipping and training coordinators

Background Information
Support in the following areas: Technical updates in FANC, Basin Emergency Obstetric and Newborn Care this has been incorporated in midwifery curriculum development: Supporting movement of Advanced Diploma to Bachelor Degree (NTA 8) program, especially for Midwifery

Focused Antenatal Care to Nurse tutors

Jhpiego started FANC training to providers working in Reproductive and Child Health Clinics in 2004 Incorporating FANC materials to N&M curriculum FANC training to nurse tutors from all nursing schools in Tanzania Follow up of graduates to see how many are working in RCH clinic after being trained on FANC

Emergency Obstetric and Newborn Care

Support of MOHSW in development of curriculum there are two modules for EmONC EmONC facilitators guide which will be used by nurse tutors EmONC student manual which will provided to student Training of midwifery tutors on EmONC, so that they will be able to train students, so far we have trained 20 tutors Provision of training materials to nursing and midwifery schools

Strengthen midwifery to save lives

A well performing health workforce is seen as one of the six building blocks of a health system (WHO 2007) specifically that workers are competent, responsive and productive therefore addressing the pre- service education of midwives is a critical action for improving the quality of maternity care.

Ensuring enabling environment with adequate resources

Provision of teaching aids Lap tops and LCDs to schools and training on how to use them 67 laptop computers and LCD projectors were provided to nursing/midwifery schools, and tutors were trained how to use them Institutionalization of skill laboratories

Training in how to organize and use a skills lab

Training in organizing a skills laboratory

Competency Based Training

Communication and malaria Initiative in Tanzania( COMMIT) in NM schools

Improve interpersonal communication (IPC) skills of health care providers to address malaria prevention and case management - Integration into pre-service education -Training of 190 Nurse tutors on Interpersonal communications - Distribution of training materials and job aids to tutors - Integration into other ongoing training activities as possible - training of trainers

Harmonization Midwifery Scope of Practice

Mozambique is now the first country in the world to train specialised midwives to perform major obstetric surgery
Other African countries to explore the possibilities for NM with Bachelor degree in midwifery to perform obstetric surgery

The example from Mozambique:

Specialized midwives performing obstetric surgeries;- Hysterectomies - Laparotomies for - Removal of Ectopic Pregnancies

The End

Thank you for listening

Challenges
Shortage of nurse tutors Shortage of supplies and equipment at the clinical areas Different midwifery scope of Practice and competences among midwives within ECSACON member countries.