Continuous professional development of Liberia's midwifery workforce—A coordinated multi-stakeholder approach
Section snippets
Background
While progress has been made in the reduction of child mortality, the maternal mortality ratio remains very high, with an estimated 1072 deaths per 100,000 live births reported, according to the Liberian Demographic Health Survey 2013 (Ministry of Health and Social Welfare [Liberia] 2014). In Liberia, access to quality maternal and newborn care is lower in rural areas than in urban areas. Evidence shows that maternal and newborn care can be improved through access to acceptable and high-quality
The new model: continuing professional development of midwives in Liberia
The CPD programme developed by the Liberian Board of Nurses and Midwives is embedded within a regulatory framework. The need to continuously maintain midwifery competencies through training, mentoring, and development of clinical decision-making skills and career advancement, is overseen by the regulatory body to ensure quality in the provision of these activities. This is an innovative and novel approach in the region (Fig. 1).
The Liberian Board for Nursing and Midwifery together with the
Pilot of CPD programme
The pilot project was established in 2017 by the Ministry of Health with technical assistance of EPOS Health Management, UNFPA, Jhpiego and New York University Meyers. It is comprised of two components aiming to improve the quality of care provided by midwives and others with midwifery skills, such as nurses working in Grand Gedeh county and other counties with high maternal mortality:
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Mentoring of midwives.
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Mobile learning and skills training.
Mentoring as the first component was established by
Successes and challenges
A baseline assessment in 2016 of several facilities, including clinics, health centres, and hospitals showed that the availability of a consistent electrical power supply varied. To prepare for the project and to ensure that the smartphones can be charged by the midwives, electricity supply through solar power source was installed.
Other challenges identified were poor road conditions, especially in the rainy season and a weak communication system. These additional challenges not only hampered
Sustainability of the programme
The CPD programme has been established by the regulatory body of midwives in Liberia. In order to practice, midwives need to register with the Liberian Board for Nursing and Midwifery and licenses need to be renewed on an annual basis. The newly developed CPD programme links maintenance of professional competence through continued training/education and mentoring, with a legal practice requirement.
The mentoring program, once fully established and with the involvement of County Health Teams,
Conclusion
The CPD programme of the Liberian Board for Nursing and Midwifery, currently in pilot-testing by various partners, aims to highlight the positive impact of the coordinating role of both the regulatory body and health authorities. Using regular process and programme reviews to improve capacity, knowledge, and skills of health professionals.
Acknowledgements
Funding: The piloting of the COD programme was financially supported by the Delegation of the European Union to Liberia1 [project number FED/2014/351/044]; the Swedish International Development Assistance; We are thankful to Jhpiego who gave their permission to use the e-learning modules and to Laerdal Global Health which donated MamaNatalies for the
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