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The Federal Government of Ethiopia has committed itself to the Millennium Development Goals outlined in the Millennium Declarations of 2000. Of particular challenge to the Federal Ministry of Health and related Ministries is the achievement of MDG 4 and 5 pertaining to the reduction of maternal and infant mortality by three fourth and two third respectively by 2015 from their unacceptably high levels in 1990.
The maternal mortality ratio at the commencement of the initiative was at 673 deaths per 100,000 live births (Ethiopia Demographic and Health Survey 2005) and the vast majority of deliveries (94%) take place at home in the absence of trained personnel with midwifery skills. Coverage of postnatal care is also extremely low at 5% (Ethiopia Demographic and Health Survey 2005).
The major cause of maternal deaths include: obstetric hemorrhage, sepsis, pregnancy related hypertensive disorders, abortion and obstructed labor.
The challenge to provide the life-saving obstetric care among the most deprived women in Ethiopia is made almost impossible by the shortage of midwives and doctors particularly in rural areas.
Goal and Objectives
The goal of Accelerated Midwifery Training Initiative is to contribute for the attainment of MDG 4 & 5 through rapid training and deployment of minimum number of skilled attendants at all Health Centers within shorter time
Implementation Strategy
The implementation strategy of the initiative is designed to produces competent level Iv Midwives within short period of time i.e 12 months by developing modular Competency- based curriculum & enrolling graduates from both privet & government nursing schools who have no job.
The initiative has been intended to be held from January 2011 to December 2013 i.e. for a period of three years to attain the target of this short term strategy.
Achievements
- 4,461 students graduated from three rounds of the accelerated midwifery training program. This leads to 95% achievement of the program target.
- A total of 189 Tutors/Instructors have received Effective Teaching Skills.
- The number of deliveries increased from 4,995 from May 2011 to April 2012 before deployment of accelerated midwives graduates to 8,042 from May 2012 to April 2013 after deployment of midwives. This shows a 61% increase
- Since the beginning of the program the capacities of involved heath science colleges have been progressively increasing in terms of skill lab equipments, recent editions of midwifery education books, faculty development, teaching aid equipments, etc
- The program addresses two major related challenges of the country.
- Large number of unemployed young nurse professionals.
- Critical shortage of the Midwifery professionals.
- Trainees enrolled from their respective locality and deployed back in their respective locality is found to be the best experience for:-
1. The retention of professionals; and
2. The commitment accesses skilled birth attendant
Challenges
The following areas have been the critical challenges throughout the program implementation period:
- Critical shortage senior midwifery tutors with clinical experience.
- High turnover of tutors due to HSCs lack motivation and retention mechanism
- High students to tutors ratio.
Future plan
In upcoming years, the major focus will be given on quality assurance and capacity building of training institutions. Accordingly:
- Provide educational materials to training institutions and practicum sites
- Build the capacity of teachers and support provision of teachers to the training institutions
- Undertake induction training for new midwifery graduates