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

Program Update

RMF Promoting Midwifery Education

It has been more than a year since the Bachelor of Midwifery Sciences (BMS) program was introduced in Nepal. The program is slowly gaining recognition, but there is still much work to be done to effectively increase the number of skilled, competent midwives who will reduce maternal and neonatal mortality rates in the coming days. The government of Nepal and partners remain invested in the program, with high hopes of effectiveness in the area of maternal and newborn health.

Between October and December of 2018, RMF was involved in the following activities to promote midwifery education and awareness in Nepal:

• RMF participated in a Stakeholder Consultation and Dissemination Workshop on PCL midwifery curriculum, organized by the Nursing and Social Security Division of the Department of Health Services.
• RMF participated in a workshop on workforce planning for SRMNAH services with a focus on midwives.
• RMF’s scholarship distribution program was organized to award one scholarship to a midwifery student.

Stakeholder Consultation and Dissemination Workshop

PCL Midwifery Curriculum

On November 27, 2018, the Nursing and Social Security Division of the Department of Health Services, Ministry of Health and Population, organized a workshop to disseminate updates and establish acceptance of the PCL midwifery program curriculum. The chief guest of the event was Minister of Health Upendra Yadav. Among the distinguished guests were Nepal Nursing Council President Prof. Goma Devi Niraula, MIDSON President Prof. Kiran Bajracharya, Chief of Curative Service Division of Ministry of Health Dr. Bikash Lamichhane, and Karnali Academy of Health Sciences VC Prof. Dr. Rajendra Wagley. The attendees included representatives from various departments within the Ministry of Health, external development partners (EPDs) including RMF, and representatives from various professional organizations and academic institutions related to nursing.

The workshop began with an introduction and updates on the Proficiency Certificate Level (PCL) midwifery program, as well as an overview of the challenges faced in its implementation. Director of the Nursing and Social Security Division of Ministry of Health Roshani Tuitui explained the objectives of the program, the ongoing processes, and the way forward.

In the second session of the workshop, the curriculum of the PCL midwifery program, as well as the minimum prerequisites for an institution to initiate the program, were distributed among the participants who discussed the details to reach a consensus. The program was thus completed with the dissemination of the finalized curriculum, implementing organization prerequisites, and feedback from the guests.

Workforce Planning for SRMNAH Services

Focus on Midwives

During the reporting period, a workshop was organized by the Nursing and Social Security Division of the Department of Health Services regarding workforce planning for sexual, reproductive, maternal, neonatal, and adolescent health (SRMNAH) services with a focus on midwives. The objective of the workshop was to receive input from various sectors in order to support the federal workforce planning process of the healthcare system, particularly in regard to midwives.

During the second session of the workshop, participants were divided into groups to work on plans for the implementation of midwifery education, workforce planning according to the given context, improvement and utilization of the available infrastructure, midwife deployment, and motivating factors for healthcare human resources. As the participants were highly experienced policy makers, researchers, and other experts from multiple faculties, they did an excellent job providing abundant input, and the workshop was a success as a result of their diligent work.

RMF Scholarship Distribution Program

December 23, 2018

The RMF scholarship is provided to a government employee who secures a position on the merit list of the entrance examination held by NAMS and is not provided with remuneration by the government during the study period. The scholarship covers all tuition fees. The National Academy of Medical Sciences (NAMS) Bir Hospital Nursing Campus(BHNC) organized a special program on December 23, 2018 to welcome a new intake of students. The students were enrolled in the Master of Nursing, Bachelor of Nursing Sciences, and Bachelor of Midwifery Sciences programs. The students accepted into these programs had earned their places based on the entrance exam conducted by the NAMS examination board.

Despite their busy schedules, acting Vice Chancellor of NAMS Prof. Dr. Subodh Adhikari and NAMS Bir Hospital Director Prof. Dr. Bhupendra Basnet attended the scholarship distribution program. Bir Hospital Campus Chief Prof. Pramila Dewan greeted all the guests and welcomed the new students to the program. She explained how the academic programs at NAMS have been able to produce high quality health professionals that provide valuable services throughout Nepal. She also described the challenges faced by the institution in maintaining the campus: they do not have an adequate building for academic purposes and must accommodate students in a hostel, and they have insufficient faculty to run the various programs. Thus, she asked the NAMS administration to help the Bir Hospital Nursing Campus to address these issues. She stressed that although there were numerous challenges in running the institution, the quality education of the students has been and always will be the first priority. In closing, Prof. Dewan expressed her gratitude to RMF for its support. After Prof. Dewan’s speech, the students were welcomed by their respective faculties with tika, a Nepali celebratory tradition in which a bright pigment is applied to the forehead.

In his speech, RMF Program Manager Ganesh Shrestha introduced RMF and its CEO Dr. Martina Fuchs to the attendees. He elaborated on the role of RMF in the consortium supporting midwifery education and the purpose of the scholarship itself. He also expressed his gratitude towards Prof. Pramila Dewan and the NAMS family for maintaining a respectful relationship with RMF and commitment to continuing scholarship support in the future.

In the meantime, NAMS Vice Chancellor Prof. Dr. Subodh Adhikari distributed scholarship checks to the RMF scholarship recipients. These students were Pratiksha Gurung and Muna Tembe Limbu of the Bachelor of Midwifery Sciences program.

In his speech, Prof. Dr. Adhikari said that it was a privilege to attend the program. He had not previously had the chance to visit Bir Hospital Nursing Campus and thus did not know the challenges it faces. He committed to supporting the campus by any means and asked BHNC administration to first find a suitable building for its programs. He also addressed the new students and asked them to put their best work into their studies so they can provide high quality services after completing their training; as a result, NAMS will take pride in producing such a high level of health professionals. In conclusion, he thanked RMF for providing invaluable support to BHNC.

RMF Scholarship Recipient

Muna Tembe Limbu

Muna Tembe Limbu, a student in the Bachelor of Midwifery Sciences (BMS) program at NAMS, was chosen to receive an RMF scholarship. She is an employee of the Nepal government in the health sector, as a staff nurse. Muna had worked at the Ghorlikharka Health Post and Tamku Primary Health Care Center (PHCC) in Taplejung for 3 years. She is from the mountainous Taplejung district, where she grew up in a lower middle-class family and longed to complete her studies in order to support her father financially. Muna also had a strong grasp of her own capabilities and a passion to build her confidence, which allowed her to pursue an education in nursing.

When Muna worked at Tamku PHCC, she witnessed the experiences of pregnant women during childbirth. Though she could handle many of the clients efficiently, some of them had to be referred to more advanced health centers. However, the location of Tamku PHCC was so remote that the life of the both mother and child were often at stake during referral periods. Muna understood that if they could identify risky pregnancies earlier, they could refer them sooner and save lives. Her passion for preventing maternal and neonatal deaths led her to apply for the NAMS Bachelor of Midwifery Sciences program as soon as she learned about it, and she was placed on the merit list on her first application. Based on her financial background and her lack of a government stipend for the academic period, she applied for the RMF scholarship and was selected as an awardee from a group of other government employees studying at NAMS.

Conclusion

Working Together for Change

As the number of participating universities grows and their capacity is increased through educational materials, technology, faculty training, and more, the government of Nepal and consortium of partners, including RMF, believes that a large-scale change can be affected in women’s and neonatal health through the increasing numbers of well-qualified midwives in the country.