Innovative approach in building capacity of midwives through field-based mentorship program
Midwives working in remote facilities have little opportunity to receive technical support and coaching services from certified midwifery trainers due to the direct and opportunity costs incurred in regular institutional training for both midwives and the health system. To close this gap Afghan Midwives Association (AMA), in line with its mandate of supporting midwives, designed a novel field-based mentorship program in which certified national midwifery trainers are tasked to travel to health facilities and provide coaching services to the midwives working there. The mentorship program has contributed in increasing the visibility, status, and respect of midwives within their communities. As a result, the demand for midwifery services increased among community members.
AMA’s mentorship model trains experienced midwives to mentor recent graduates posted at periphery health facilities and supports them to conduct:
- Needs assessment of mentee skills
- 3 Times Routine visits for onsite coaching
- Assessment of mentee skill retention using national quality performance standards for antenatal care (ANC), normal and complicated labor and delivery, and postnatal care (PNC)
- Assessment of facility infrastructure, supplies, equipment and management support for maternal and new-born health services
The program was initiated in 28 health facilities in six provinces of Afghanistan. During the implementation, participating facilities improved performance in ANC performance from 20% to 88%, labor/delivery performance from 19% to 85%, complicated labor/delivery performance from 15% to 94% and PNC performance from 16% to 94%. Average scores for MNH service support increased from 38% to 81% over the same period. In the second and third years of implementation, additional facilities were included, with average scores improving from similarly low levels to more than 70%.
To date, the AMA Mentorship Project has successfully supported more than 80 midwives to mentor nearly 200 colleagues, strengthening the professional capacity of midwives in nine provinces of Afghanistan, increasing acknowledgment of midwifery profession among health workers and acceptance among community members. The program is ongoing with plans for expansion; however, further research and support is needed before considering the program a successful model for in-service education and investing in scale up nation-wide.