Participants simulate the birthing process during training session
Several studies indicate that North and North-Eastern Uganda are some of the areas within the country that have the least developed rural areas, low primary education performance and high maternal mortality rates. When the Aga Khan University School of Nursing and Midwifery (AKU-SONAM) team in Uganda carried out a training needs assessment in Nwoya district, Northern Uganda, they discovered that the most pressing health concerns involved low confidence by nurses in their ability to manage the leading causes of maternal deaths.
“The training needs assessment indicated that while midwives and obstetric nurses were familiar with Helping Mothers Survive components such as postpartum haemorrhage, preeclampsia and eclampsia, obstructed labour among others, many lacked the confidence and competence to deal with these conditions as emergencies," says Lillian Nuwabaine, coordinator of the Continuous Professional Development (CPD) courses at AKU-SONAM in Uganda. The School moved swiftly to establish a Helping Mothers Survive short course for nurses based in different health centres within Nwoya district including Anaka General Hospital, Lulyango Health Centre II, Gods' Mercy Medical Clinic and several other health centres.
The training took place between 12th and 15th October with 20 participants who were accommodated within a single training environment throughout the course to limit community interaction and maintain COVID-19 protocols. “We maintained all the safety protocols but preferred to conduct the training face-to-face because we had to demonstrate several actions through the dummies and manikins," said Lillian. She added: “face-to-face training also made for better discussions compared to the online sessions as the participants were able to exhaustively share their personal experiences without network challenges."
During the training, participants learned how to handle various aspects of life-threatening emergencies that mothers and babies face during pregnancy, labour and birth. They simulated various delivery procedures and anticipated several scenarios that would be useful during obstetric emergencies. However, the workshop also brought to the fore several challenges that nurses and midwives face daily at work and fortunately, the AKU-SONAM team had facilitated the presence of the Nwoya District leadership for part of the training. The district leadership who availed themselves included the District Health Officer - Dr Janet Oola, Assistant District Health Officer - Mr Isaac Wonyima, Chief Administrative Officer - Mr Nkugwa Nobert Robert and his deputy - Mrs Jesca Ongiertho. Some of the participants voiced their concerns on various issues with one stating: “there is one blood pressure machine at our general hospital in the ante-natal area and currently it is not working." Most of the concerns were around under-staffing, inadequate equipment and lack of support by leadership. Lillian shared that: “The presence of the district health leadership was an opportunity for them to reinforce their commitment to supporting midwives and nurses and also helped them realize the importance of such in-service training opportunities. They promised to continue collaborating with AKU to work on reducing maternal and neonatal morbidity and mortality in the region."
Since 2018, AKU-SONAM East Africa has been conducting continuous professional development courses for nurses and midwives in Kenya, Uganda and Tanzania.