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Strengthen Lesotho’s midwifery services: UNFPA

Limpho Sello

LESOTHO’S midwifery services must be strengthened to prevent maternal, newborn and infant mortality, the United Nations Populations Fund (UNFPA) representative in Lesotho, Marc Derveeuw, has said.

Dr Derveeuw said this during a recent validation meeting for the Midwifery Gap Analysis Report and Road Map at a local hotel.

Dr Derveeuw said it is also important to strengthen midwifery focusing on the pre-service education (PSE), regulation, association and services to improve access to quality maternal and neonatal healthcare services which will result in improved health care outcomes for women and their newborns. He said there were major gaps in the four different pillars for example the lack of basic system requirements in midwifery schools thereby compromising the quality of education.

“There is a basic regulation for nurses in Lesotho but this has little impact on midwifery for example the report highlights that no licensure and re-licensure for midwives and regulations are midwifery specific,” Dr Derveeuw said.

“The midwifery association exists but it is very weak and needs considerable attention.”

Dr Derveeuw said the country still has serious gaps that include shortage of staff, lack of equipment and the absence of an induction programme, retention strategy and hardship allowance for those who are working in hard to reach areas.

“I therefore commend the Ministry of Health for the leadership and commitment to this process of reviewing the Gaps in Midwifery and development of the road map that aims at improving midwifery to reduce maternal mortality.

“I would like to believe that this assessment has covered three pillars of midwifery regulation, associations and education and looks into services and administration. I also believe that all this is linked to the Midwifery Services Framework as recommended by the International Confederation of Midwives,” Dr Derveeuw said.

Dr Derveeuw said he hoped that the Ministry of Health would continue to convene all stakeholders to ensure the success of the road map and the full implementation of the recommendations.

“It is my sincere hope that this assessment and the road map will help the Ministry of Health to come up with important policy changes that will improve midwifery as a tool to reduce maternal mortality,” Dr Derveeuw said.

He also commended the Ministry of Health for its progress that they have made in reducing maternal mortality and ensuring that a high number of women go for antenatal care (ANC).

“Let me commend Lesotho for making good progress in some important indicators towards reducing maternal mortality where, the 2014 Lesotho Demographic Health Survey (LDHS) indicates that, 95 percent of women who gave birth received ANC from a skilled provider. About 74 percent of these women had four or more ANC visits; and approximately 77 percent of births occurred in a health facility, with the majority of births at 61 percent were attended by a nurse-midwife,” Dr Derveeuw said.

Midwifery services consultant Farida Shah said when educated to international standards and within a fully functional health system, midwives can provide about 90 percent of the essential care to women and newborn babies and potentially reduce maternal and newborn deaths by 33 percent.

Ms Shah said if midwives were authorised to perform the full range of midwifery practice including family planning and interventions for maternal and newborn health, they could avert 83 percent of all maternal deaths, stillbirths and neonatal deaths.

“There are substantial evidences that midwifery can make a key contribution in ensuring high quality maternal and newborn care. However, this can only be possible if midwives are well educated, resourced, and regulated,” Ms Shah said.

She said the needs for midwifery workforce have been ignored in both developed and developing countries.

“Sadly, these efforts have resulted in a focus on quantity over quality and have led to the introduction of various cadres of multipurpose workers without having full range of midwifery competencies and limited authority,” she said.

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