Nepal: Partnership with MOHP, UNFPA, WHO and GIZ to foster Midwifery Education
Maintaining Partnerships, Working to Fill the Midwifery Gap: February 1 – July 31, 2016
September 08, 2016
Summary of Activities
In Nepal, the profession of nursing evolved from midwifery services and midwives. However, the nursing profession has continued to gain prominence, while there has been little improvement in midwifery services or the number of midwives in Nepal. This is because the services of a professional midwife are typically provided by assistant nurse midwives, nurses, and general physicians. To the detriment of Nepal’s vastly rural population, most of these professionals prefer to stay in the capital or urban areas, where there is an abundance of medical expertise.
RMF is working in collaboration towards these goals:
- Meet the increasing future need for professional midwives
- Address the current shortage of professional midwives (especially in rural areas)
- Achieve the Nepal government’s expected 2030 results by addressing the issues of high infant and maternal mortality rates though long-term, sustainable solutions
The Ministry of Health and Population (MOHP) , with the support of organizations such as UNFPA, WHO, GIZ, RMF, and IMC, is helping universities formulate a curriculum and offer an accredited degree that is on par with the international standards of the World Health Organization (WHO) and the International Confederation of Midwives (ICM) .
8 Million Impacted
After the April 2015 earthquake, up to 90% of health facilities were damaged or destroyed in many rural areas. Included in those impacted are 2 million women of reproductive age and over 126,000 pregnant women.
According to WHO, over 85% of urban pregnancies in Nepal are over medicalized, with mothers receiving overwhelming prenatal care even for simple and nonfatal cases. However, only 16% to 18.6% of Nepal’s population lives in its cities.
High Mortality Rates
Most people live in rural areas, and many of these areas are deprived of professional midwifery services, modern medicines, and access to surgery. When pregnancy complications arise, this lack of proper care leads to the death of the mother and child in most cases.
More Midwives Needed
The population is projected to reach a total of 32.9 million by the year 2030, and Nepal will face even more urgent shortages of these professionals, especially in rural areas.
In 2006, Nepal’s Ministry of Health and Population (MOHP) introduced the National Policy of Skilled Birth Attendants with an aim to bring about sustainable development and reduce the mother and child mortality rates. In 2009, MOHP finalized its selection of 4 universities to pioneer midwifery education as a professionally accredited degree in Nepal. These universities are:
- B.P. Koirala Institute of Health Sciences (BPKIHS),
- Kathmandu University (KU),
- National Academy of Medical Sciences (NAMS), and
- Patan Academy of Health Sciences (PAHS).
It was agreed that the universities would establish professional midwifery education as a separate faculty within the university and offer a bachelor’s degree in midwifery as a professionally accredited course. The curriculum would be proposed by each university to the Nepal Nursing Council (NNC) for review and finalization. The NNC would offer accreditation to the proposed curriculum only if it was confirmed to be consistent with ICM/WHO international standards.
1. Address gaps in human resources, including faculty development
2. Provide scholarships for students from underserved communities
3. Support infrastructure development: i.e. classrooms, hostel facility
4. Acquire Skills Lab/Equipment (dummy/ anatomical models)
Mortality Rates Decrease
Maternal Mortality Rates*
- 750 per 100,000 in 1996
- 285 per 100,000 by 2014
- 70 per 100,000 is the goal for 2030
Infant Mortality Rate*
- 53 per 1,000 in the year 1990
- 23 per 1,000 by 2014
- 1 per 1,000 is the goal for 2030
There has also been a substantial decrease in the mortality rate of infants within 28 days of their birth.
*According to data published by MOHP
Our Expertise & Support
As part of RMF’s goal to liberate human potential by empowering local people to create long-term, sustainable change in their communities, RMF Nepal has been invited by UNFPA’s leadership to join the MOHP’s task force to educate and deploy midwives.
RMF was invited, in part because we can offer specialized support and expertise, having co-founded the first accredited college of nursing and midwifery in South Sudan, the Juba College of Nursing and Midwifery (JCONAM) in early 2010, which offers a 3-year diploma in nursing and midwifery.
Support will be implemented in close collaboration with the MOHP, UNFPA, WHO, GIZ, and IMC:
Development & Strengthening of Faculty
- Supporting the universities in recruiting faculty members,
- Sponsoring training and capacity building/skills development programs for faculty members, and
- Contributing to the remuneration of technical staff.
- Providing scholarships to needy students from economically and socially disadvantaged and marginalized backgrounds and
- Covering accommodation costs and potentially providing stipends to selected students.
Infrastructure & Equipment
- Covering the cost of necessary physical infrastructure,
- Providing equipment for training labs, and
- Supporting infrastructure improvements requested by one of the universities, Patan Academy of Health Sciences (PAHS).