Zim nursing schools producing half-baked midwives

Government nursing schools are producing half-baked midwives through short cut training and employing unqualified midwifery tutors in efforts to fill vacant posts. The Zimbabwe Confederation of Midwives revealed this in response to questions why Zimbabwe's Maternal Mortality Ratio continues to worsen since 1994.
The Zimbabwe Demographic Health Survey (2010-2011) released recently says MMR now stands at 960 per 100 000 live births.
This means one in every 100 women dies while giving birth or when a hospital assists an average of 50 women to deliver daily, then someone dies in every two days.
The current figure is an increase from the previous high of 725 per             100 000 live births released in 2007. 
Statistics from the 2010 Millennium Development Goals status report show that in 1994 the MMR was 283 per 100 000 live births, rising to 695 in 1999 before declining to 555 between 2005 and 2006. 
In 2007, the rate peaked again to 725 and now it stands at 960 deaths for every 100 000 live births.
"It is disheartening to have such a high MMR, whilst a lot of funds are being injected into maternal and child health issues. ZICOM believes that there is a missing link," ZICOM president Mrs Grace Danda said.
Zimbabwe's MDG target for MMR is 174 per 100 000 live births.
Mrs Danda said according to the International Confederation of Midwives, the three pillars for safe motherhood are education, regulation and association strengthening.
"There is more emphasis on increasing the number of midwives being trained but our question as an association is who is training them?"
She said a quick survey on the schools of midwifery in Zimbabwe showed a critical shortage of midwifery tutors while their qualifications leave a lot to be desired. 
"We can fight to train even thousands of midwives per year but are we producing quality or quantity? 
"We are ending up producing half-cooked midwives who are not trained according to ICM essential competencies," she said.
Mrs Danda criticised Government's policy, which allows primary care nurses â€" popularly known as PCNs to undergo further six-month training in midwifery to make them midwives.
She described this as a "dangerous shortcut".
"They are quite vital in the districts and rural health centres for general nursing services but the association feels they are not adequately qualified to cover for midwife shortages." 
Most rural health centres are manned by PCNs.
"As ZICOM, we do not support the approach â€" we say no poor options for the poor majority in the rural areas."
Health and Child Welfare Secretary Dr Gerald Gwinji acknowledged the shortage of midwifery tutors and its negative implications on quantity and quality of training.
He however, said people do not stop giving birth because there is a shortage of midwives.
"We are very short of midwives tutors and indeed this has effects on quantity and quality of training. 
"However, should we stop training until we have enough tutors? 
"Not at all, we use experienced midwives to fill the gap while we train more tutors," Dr Gwinji said.
On PCNs, Dr Gwinji said, the midwifery skills attained during the six-month training are necessary to identify challenges.
"All student nurses get some form of midwifery skills during training, we are just trying to give a bit more skills to PCNs  who are right on the front line in the remotest of all places √ɬ¢√¢‚Äö¬¨" not to make them fully fledged  midwives," he said.
According to ZDHS (2010-2011), 31 percent of live births in the five years preceding the survey were delivered by a nurse.
Last year, only 22 percent of posts for midwives were filled (UNFPA) but now ZICOM says most institutions have an average of 50 percent midwives.
She attributed the increase to Government's policy of sending all midwives to maternity and also allowing locums by midwives in all maternity units. 
Zimbabwe midwives joined the rest of the world on last week on May 5 to recognise the International Day of the Midwife.
The world theme was "The world needs midwives, now more than ever," but ZICOM has localised it to read Zimbabwe needs even more midwives than the rest of the world because of the very shocking maternal mortality of 960 deaths for every 100 000 live births.
In her statement released a fortnight ago following release of the shocking increase of MMR, Deputy Prime Minister Thokhozani Khupe attributed the increase to user fees and decay of the primary healthcare.
"As the Ambassador of Goodwill for (Campaign for Accelerated Reduction of Maternal Mortality in Africa) CARMMA, I call for the speedy implementation of the policy on the removal of user fees. 
"I call for the urgent disbursement of funds extended through the Multi-Donor Health Fund as well as the financial support pledged by the Zimbabwean Government towards this endeavour," DPM Khupe said.
The Ministry of Health and Child Welfare said it is still working on modalities of disbursing the funds.
DPM Khupe has raised US$100 000 for the Fund.