CAREERS STUDENT LIFE Students Kaya Collingwood, left, and Emily Marler, right, with LAMRN country lead for Malawi Angela Chimwaza
There were many parallels in the competencies required by the Malawi regulator and the UK’s Nursing and Midwifery Council, such as undertaking 40 normal vaginal births and 60 postnatal examinations. But we were surprised by some of the additional competencies required in Malawi, including two breech births, two multiple births and six vacuum extraction deliveries.
Silent labour
Rewarding mission Kaya Collingwood and Emily Marler gained valuable insights while on their midwifery placement in south east Africa As part of our placement, we travelled to Malawi last year to attend a Lugina Africa Midwives Research Network (LAMRN) workshop, and to gain experience of midwifery there. Named in honour of the late pioneering professor of midwifery Helen Lugina, LAMRN was set up to improve clinical outcomes by establishing a network of practitioner researchers and leaders in east, central and southern Africa.
Malawi: the statistics Population (2011)
15 million
Women of child bearing age (2011)
Approximately 7.5 million
Maternal Mortality Rate (MMR) (2013)
510 per 100,000 live births
UK MMR (2013)
8 per 100,000 live births
Infant Mortality Rate (IMR) 2004
76 per 1,000 live births
IMR (2010)
66 per 1,000 live births
UK IMR (2013)
4.2 per 1,000 live births
Sources: World Bank, Office for National Statistics
The workshop focused on various projects carried out by the Malawi midwives. The days were packed with information and discussion, broken up occasionally with prayer, dance and singing. One study focused on the clinical outcomes of using the partograph, an inexpensive paper tool developed in Africa and used to record labour progress, and promote early recognition and management of prolonged and obstructed labour. In Malawi, it seemed that the partograph was used inappropriately or not at all. We spent the second week observing midwifery practice in a large hospital in Blantyre, South Malawi, where there were as many as 35 deliveries every day. One of our objectives was to understand student midwife training in Malawi. All midwifery students complete a three-year nursing degree before undertaking two years of midwifery. The dean of the University of Malawi is now developing a direct-entry midwifery degree similar to that in the UK.
It is accepted that Malawi women endure labour and childbirth in silence, often without pain relief. Although pethidine was available, we did not see any women request it. Women were not given information or many choices about their care and the woman-centered approach that we are so used to in the UK appeared to be absent. However, with only two qualified midwives and a few students caring for about 14 women, time was inevitably limited. This experience gave us incredible insight into clinical practice in a low-income setting and the importance of collaborative approaches. As a way of showing our appreciation, we are raising funds to sponsor three midwives to attend the first LAMRN annual conference, taking place next week in Tanzania (see resources) NS Kaya Collingwood and Emily Marler were third-year midwifery students at the University of Manchester. They graduated in December RESOURCES LAMRN network www.LAMRN.org To donate to Malawi students attending LAMRN conference tinyurl.com/LAMRNdonate
66 march 4 :: vol 29 RCNi.com no 27 :: 2015 STANDARD Downloaded from by ${individualUser.displayName} on Nov 29, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
There were many parallels in the competencies required by the Malawi regulator and the UK’s Nursing and Midwifery Council, such as undertaking 40 normal vaginal births and 60 postnatal examinations. But we were surprised by some of the additional competencies required in Malawi, including two breech births, two multiple births and six vacuum extraction deliveries.
Silent labour
Rewarding mission Kaya Collingwood and Emily Marler gained valuable insights while on their midwifery placement in south east Africa As part of our placement, we travelled to Malawi last year to attend a Lugina Africa Midwives Research Network (LAMRN) workshop, and to gain experience of midwifery there. Named in honour of the late pioneering professor of midwifery Helen Lugina, LAMRN was set up to improve clinical outcomes by establishing a network of practitioner researchers and leaders in east, central and southern Africa.
Malawi: the statistics Population (2011)
15 million
Women of child bearing age (2011)
Approximately 7.5 million
Maternal Mortality Rate (MMR) (2013)
510 per 100,000 live births
UK MMR (2013)
8 per 100,000 live births
Infant Mortality Rate (IMR) 2004
76 per 1,000 live births
IMR (2010)
66 per 1,000 live births
UK IMR (2013)
4.2 per 1,000 live births
Sources: World Bank, Office for National Statistics
The workshop focused on various projects carried out by the Malawi midwives. The days were packed with information and discussion, broken up occasionally with prayer, dance and singing. One study focused on the clinical outcomes of using the partograph, an inexpensive paper tool developed in Africa and used to record labour progress, and promote early recognition and management of prolonged and obstructed labour. In Malawi, it seemed that the partograph was used inappropriately or not at all. We spent the second week observing midwifery practice in a large hospital in Blantyre, South Malawi, where there were as many as 35 deliveries every day. One of our objectives was to understand student midwife training in Malawi. All midwifery students complete a three-year nursing degree before undertaking two years of midwifery. The dean of the University of Malawi is now developing a direct-entry midwifery degree similar to that in the UK.
It is accepted that Malawi women endure labour and childbirth in silence, often without pain relief. Although pethidine was available, we did not see any women request it. Women were not given information or many choices about their care and the woman-centered approach that we are so used to in the UK appeared to be absent. However, with only two qualified midwives and a few students caring for about 14 women, time was inevitably limited. This experience gave us incredible insight into clinical practice in a low-income setting and the importance of collaborative approaches. As a way of showing our appreciation, we are raising funds to sponsor three midwives to attend the first LAMRN annual conference, taking place next week in Tanzania (see resources) NS Kaya Collingwood and Emily Marler were third-year midwifery students at the University of Manchester. They graduated in December RESOURCES LAMRN network www.LAMRN.org To donate to Malawi students attending LAMRN conference tinyurl.com/LAMRNdonate
66 march 4 :: vol 29 RCNi.com no 27 :: 2015 STANDARD Downloaded from by ${individualUser.displayName} on Nov 29, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
