Nepal: Partnership with MOHP, UNFPA, WHO and GIZ to foster Midwifery Education

Background

Earthquake Adds to Urgent Women's Health Issues

After the earthquake, up to 90% of health facilities in many rural areas are known to be damaged or destroyed. For example, in Rasuwa district, up to 78% of district health facilities are reported to be completely demolished, and only two health posts remain functional. Hospitals in district capitals, including Kathmandu, have been overwhelmed, medical supplies severely depleted and capacities overstretched. Out of a total of 352 birthing centers, 115 were totally damaged and 137 partially damaged. Overall, the April 25 earthquake affected some 8 million people, including 2 million women of reproductive age and over 126,000 pregnant women.

Even before the earthquake, out of an estimated total population of 27.5 million, 23 million (84%) were living in rural areas and 7.4 million (27%) were women of reproductive age in 2012; the total fertility rate was 2.3. By 2030, the population is projected to increase by 20% to 32.9 million. 

To achieve universal access to sexual, reproductive, maternal and newborn care, midwifery services must respond to 0.9 million pregnancies per annum by 2030, 85% of these in rural settings. The health system implications include how best to configure and equitably deploy the sexual, reproductive, maternal and newborn health (SRMNH) workforce to cover at least 70.2 million antenatal visits, 10.9 million births and 43.7 million post-partum/postnatal visits between 2012 and 2030 (UNFPA, 2014). There is a dearth of professional midwives to cater to the current and growing need; their roles will be instrumental in improving maternal and child health in rural areas. 

In this context, an MOU has been signed between 4 universities by UNFPA and MOHP, which includes introducing midwifery education as a different faculty in their universities as a professionally accredited course. Likewise, a draft bachelor's degree curriculum on midwifery has been drafted and will be tailored by the universities to suit their interests and this curriculum will be approved by the NNC (Nepal Nursing Council). 

Progress

Building Midwifery Education

Real Medicine Foundation (RMF) has been working around the globe in close collaboration with governments, ministries, donor agencies, international development partners and local stakeholders to improve the quality of and access to professional health care services and intends to contribute for the same in Nepal too. We have co-founded and established the first ever accredited College of Nursing and Midwifery in South Sudan, the Juba College of Nursing and Midwifery (JCONAM); the college offers a 3-year diploma for Registered Nursing and Midwifery. Through the provision of trained and qualified nurses and midwives, it is aimed to fill the gap of professional skilled healthcare services in the country. In particular, we are supporting through sponsorships of students, provision of skills and laboratory equipment, clinical training equipment, IT equipment, capacity enhancement of the faculty and investments in infrastructure as required.

• Development and strengthening of faculty in the chosen universities and educational institutions in close collaboration with the:

  • Ministry of Health and Population (MOHP)

  • United Nations Population Fund (UNPF)

  • World Health Organization (WHO)

  • Gesellschaft für Internationale Zusammenarbeit (GIZ)

• We intend to accomplish this by: 

  • Supporting the universities in recruiting faculty members

  • Contributing to the remuneration of the technical staffs

  • Sponsoring trainings, capacity building/skills development programs for the faculty members.

  • Supporting students from economically and socially disadvantaged and marginalized backgrounds through scholarships and covering accomodation costs and stipends to selected students. 

  • Making investments into necessary physical buildings and equipment support for one selected university.