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MOMENTUM: Developing a Model of MENTorship for Ugandan Midwifery

MOMENTUM: Developing a Model of MENTorship for Ugandan Midwifery

The RCM has received funding from the Tropical Health and Education Trust (THET) to implement a project continuing our work in Uganda, following the completion of the Global Midwifery Twinning Project (GMTP) in Cambodia, Nepal and Uganda in March 2015. MOMENTUM will run for 20 months from the 1st of September 2015 and is jointly implemented by the RCM and its partner the Uganda Private Midwives Association (UPMA). The RCM’s Global Team are managing the project and, along with the RCM’s Education Team, providing expert technical advice to the project. MOMENTUM also involves close work with the Ministry of Health, the Uganda Nurses and Midwives Council who hold responsibility for national midwifery standards in Uganda, and education institutions including universities and midwifery training schools.

The new project is called MOMENTUM: developing a Model of MENTorship for Ugandan Midwifery. MOMENTUM is part of the Health Partnerships Scheme, which is funded by the UK Department for International Development (DFID). MOMENTUM aims to address the poor quality of mentorship for student midwives in Uganda.
The project will develop:

  •     4 clinical pilot sites as centres of student mentorship excellence,
  •     a national standard for midwifery mentorship, and
  •     a module to deliver work-based learning to midwives to prepare them to become mentors.

The project will use an Action Research approach, which emphasises participation for all parties and includes cycles of action and reflection to develop the most effective solutions. Action research expertise both within the UK and Uganda will help to guide the project participants through the research element of the project, which aims to generate Ugandan solutions to midwifery mentorship challenges.

Uganda currently suffers from high maternal and newborn mortality and morbidity.

  • In 2015, Uganda’s maternal mortality rate per 100,000 births was 343, down from 360 in 2013.
  • The infant mortality rate per 1000 live births was 44 in Uganda (UK: 4).
  • In 2012 the ART coverage of eligible patients with HIV was 64%
  • Between 2011 and 2013, the average fertility rate decreased from 6.06 to 5.9
  • Between 2010 and 2015 the neonatal mortality rate has decreased from 22.1 per 1000 to 18.7 per 1000 live births.

(Source: Interagency estimates - WHO)

Midwives trained to the International Confederation of Midwives competencies are able to prevent around 2/3 of these deaths in mothers and newborns. However, student midwives in Uganda receive poor quality mentorship during their practice learning, and so are often not fully competent when they qualify. The project aims to improve the training of student midwives, to contribute to our vision of all mothers and babies in Uganda having access to quality midwifery care. The period of mentorship in student midwives practice placements has been identified as a crucial intervention point by the RCM and its in-country partners, as good quality mentorship ensures:

  • Development of practical midwifery competencies,
  • Demonstration of the achievement of the required standards for midwifery practice, and
  • Development of independent decision making capabilities and midwifery behaviours.

A successful pilot project to improve mentorship for student midwives at the Kibuli School of Nursing and Midwifery was undertaken during GMTP and has informed the design of this larger project. The pilot project placed 7 student midwives from the Kibuli School at a group of 4 Ugandan Private Midwives Association (UPMA) midwives’ clinics for their 10 day practice placements. The students really valued these placements and they noticed a difference in the attitude and behaviour of UPMA midwives compared to those in other settings. The students commented on the increased respect for women, improved communication skills, improved hospitality, and hygiene and infection control standards they observed on their placements. Following the success of this pilot project, MOMENTUM was devised to expand these placement opportunities to a wider group of midwifery students and to develop 4 clinical sites (representing the different Ugandan healthcare provider contexts) as centres for mentorship excellence.

MOMENTUM has recruited 7 RCM members as volunteers for this project. The RCM members all will visit Uganda on two occasions for four weeks each. Between visits, the volunteers will connect with their twins virtually to provide support, guidance and technical expertise. The Ugandan midwife twins will visit the UK in quarter 4 of 2016 to visit the RCM, undertake clinical site visits to understand a different context of midwifery and mentorship, and to deliver a paper at a RCM conference about developing their workplaces as sites of midwifery mentorship excellence.

For more information on MOMENTUM, see our project blogs or email global@rcm.org.uk