Rafat Jan, General Nursing' 83

Dr Rafat Jan Rukanudddi​n, General Nursing ’83, AKU; MScN, University of South Carolina ’94; PhD, University of Iowa, ’04 is currently Associate Professor at the School of Nursing and Midwifery. With a strong passion for midwifery, she became the first Director of AKU’s undergraduate midwifery programme. Dr Jan also serves as President of the Midwifery Association of Pakistan, as Chair of the South Asian Midwifery Alliance and was recently elected as a board member of the South Asian International Confederation of Midwives.

When did your association with AKU begin?
With the very first class: the Class of ‘83. On our first day, His Highness The Aga Khan came to our class and said, “work hard, work hard, work hard.” Later at the formal opening he said, “If you fail I’ve failed, if you succeed, Pakistan will be rewarded.” These words have guided me throughout my professional life. Over the years, I have seen the barren landscape change their colour to green and the small School of Nursing develop into the School of Nursing and Midwifery.

From the time you stepped into the profession, how have you seen midwifery change?
When I entered this profession, there was no higher education option for midwives. This lack contributed to the ‘non-acceptance’ of the profession and made midwives ‘invisible’ within the entire health care scenario. At the same time, the autonomous practice of midwifery was absent and in many South Asian countries the term ‘midwife’ did not even have any legal cover.

The recent launch by AKU of Pakistan’s first ever degree programme in midwifery will, I believe, have a profound impact on maternal and neonatal mortality in Pakistan, while leading to excellence in evidence-based midwifery practice, teaching and leadership. Since the programme is based on a competency-based curriculum – identifying the characteristics that graduating students should demonstrate – it is bound to serve as a prototype for countries such as Kenya, Tanzania, Uganda and Afghanistan.

Although we understand that a bachelor’s programme is absolutely necessary as a university-wide programme, we also realise that not everybody can enter a university-based programme because not everybody can be eligible. However, this does not mean that we cannot produce competent midwives. To fill in this gap, we are planning continuing professional education for midwives: short trainings in midwifery at SONAM from the platform of the Midwifery Association of Pakistan (MAP). We are training tutors for these short courses and, after much canvassing, have received funds from various
donor agencies.

I have been approached by the government to start a similar programme within the public sector in any one of the other provinces. This will build on earlier initiatives: in 2013, the United Nations Population Fund (UNFPA) funded 24 public sector candidates from the four provinces and promised that each year, till 2017, it will fund another 12 women (3 from each province) from the public sector. The Pakistan Nursing Council has also lent considerable support to our endeavours.

What role do you see the midwifery association playing in the future?
In December 2013, MAP held a formal meeting in Dubai bringing together midwives from Afghanistan, Bangladesh, India, Nepal and Pakistan. At that meeting it was agreed that South Asian Midwifery  Alliance (SAMA) would be the regional umbrella organization and the country association would fall under it. This year, at the International Confederation of Midwives Congress in Prague in June, we launched the regional online Journal of Asian Midwives; hosted by AKU library it will be an online free access journal. In 2015, we are hoping to have a meeting in Pakistan and formally launch SAMA, which will provide continuing professional education, disseminate evidence based research for midwives of the region, strengthen regulation and associations, and ultimately advocate for better care for pregnant
women and babies.