‘Midwives are the backbone of our health system’: Lessons from Afghanistan to guide expansion of midwifery in challenging settings

Abstract

the depth of midwives' contribution in Afghanistan - from increased maternal health care service utilisation to changing community's perceptions of women's education and professional independence - is overwhelmingly positive. Lessons learned can serve as a model to other low resource, post-conflict settings that are striving to increase the workforce of skilled providers.

Building midwifery educator capacity in teaching in low and lower-middle income countries. A review of the literature

“…Four of the papers were discursive (Pons et al, 2002;Fullerton et al, 2011;The RESPOND Project, 2012;Usher et al, 2012) and three based on primary research (Akiode et al, 2010;Voetagbe et al, 2010;Turkmani et al, 2013).…”

“…International educators reported that national educators were sometimes reluctant to change their teaching methods and clinical practice (Pons et al, 2002;Akiode et al, 2010;Voetagbe et al, 2010;Fullerton et al, 2011;The RESPOND Project, 2012;Usher et al, 2012;Turkmani et al, 2013). For example, Usher et al (2012) reported that, despite multiple collaborations with educators and administrators from the Pacific Island region to update curriculum with regional competency standards, some educators failed to implement the recommended changes when they returned to their home country.…”

“…Such insight may have provided useful strategies to ensure a comprehensive curriculum to facilitate effective midwifery education. Other challenges described in the papers in the review related to the lack of a standardized curriculum and inconsistent approaches to supporting student's learning within the country (The RESPOND Project, 2012;Turkmani et al, 2013), or within a region (Usher et al, 2012). These challenges were found to create significant variations in graduate competency that was complicated by the fact that the curriculum was not always aligned with national health plans.…”

“…These challenges were found to create significant variations in graduate competency that was complicated by the fact that the curriculum was not always aligned with national health plans. Although a standardized curriculum with evidence-based content was identified as a strength of a capacity building programme in Afghanistan (Turkmani et al, 2013), there were some criticisms that midwifery educators displayed a lack of professionalism by behaving disrespectfully to the students and lacked skills in the use of audiovisual aids.…”

“…Turkmani et al (2013) analysed how a lack of midwifery educators in Afghanistan were found to impact on student learning with high ratios of students to educators making it difficult to effectively supervise clinical skill acquisition (Turkmani et al, 2013). In addition, the role of the midwife was not supported by the medical profession and the skills of midwifery clinicians in the clinical placement sites were not consistent with the clinical practice of the midwifery graduates.…”