To help reduce Yemen’s maternal mortality rate,Midwives trained to manage their own private clinics [Archives:2008/1170/Health]

July 7 2008

Jamal Al-Najjar
[email protected]

Sponsored by the United States Agency for International Development, or USAID, the National Association of Yemeni Midwives, in cooperation with Shahir Foundation for training, concluded a private business management training course for midwives last week to enable them to operate their own businesses and offer mothers better health services in targeted governorates.

The June 22-29 course sought to train 15 midwives from Amran, Sa'ada, Marib, Al-Jawf and Shabwa governorates in how to run small private midwife clinics in districts of these governorates, supervised by Yemen's Ministry of Public Health and Population.

Through these clinics, the midwives will map the residents of their targeted areas so they then may do field surveillance to evaluate the prenatal care situation and come up with statistics to determine mothers' health care needs. These midwives also will count the number of children who should be vaccinated in their work areas and then follow up their vaccination doses.

Hamouda Hanafi, director of USAID's basic health services project, says these trained midwives can play an important role by offering health services to mothers in these districts, as well as reducing Yemen's maternal mortality rate, particularly given that most mothers living in remote areas lack proper maternal and prenatal care.

“In order to guarantee achieving reproductive health programs in Yemen, we should concentrate on female personnel working in the health field by giving them the proper training, as well as the chance to serve in this regard,” Hanafi says, noting that the Basic Health Services (BHS) program is working in coordination with Yemen's Health Ministry to contribute to improving maternal and prenatal services in the five governorates.

He points out that USAID's support through the BHS program to those midwives trained to manage midwife clinics is part of encouraging the private health care sector to offer society health services.

Fattoom Noor Al-Deen, coordinator of the Midwives' Private Business Program within the National Association of Yemeni Midwives, notes that the association has been working since its September 2004 establishment to give midwives a chance to operate their own private clinics.

“This course has achieved one of the association's goals, as it has trained midwives to have the necessary information in the field of management and consequently, become an active element in improving prenatal care in Yemen,” she points out.

As she explains, “We met with midwives in the five governorates, determining standards to select those to be trained to manage private clinics in their districts. Based on that, we selected three midwives from Sa'ada, four from Marib, three from Amran, two from Al-Jawf and three from Shabwa.”

Noor Al-Deen notes that USAID also will support these midwives financially to establish their own private clinics. The next step will include courses to give them the necessary knowledge and skills to reduce pregnancy and delivery complications, as well as about transferring mothers to hospitals for further health care when necessary.

Amran midwife Za'afran Saleh Al-Haddi says this most recent course was a source of encouragement for her and her fellow midwives because it equipped them to run their own clinics and receive income on the one hand, while offering better health services in the field of midwifery on the other.

“Although I am a midwife, I had no idea how to create plans or strategies to be conducted in the field of midwifery because no one was concerned about this. However, through this course, I learned a lot about surveilling a target area and coming up with statistics on pregnant mothers, those who are vaccinated and also those doing family planning. Such data helps me to determine their needs and follow up those mothers in need of health care,” she explains.

Dr. Abdurabbu Muftah, general director of Marib's Health Office, says pregnant women living in remote districts of these governorates suffer much while traveling from their districts to hospitals to receive necessary health services during pregnancy and delivery.

“These trained midwives will offer services in these districts so mothers won't have to travel from their districts to city hospitals, except for those requiring greater care or surgery,” he says, noting, “These midwives will offer better services because they'll be working within their own communities where they live.”

Yasmin Mohammed Al-Yareemi, a midwife and trainee in the course, notes that she's benefited from the course by receiving necessary information about organizing and operating a clinic, as well as creating plans to survey a certain area to determine mothers' health situations and needs.

Regardless of this training, midwives in Yemen still face many problems concerning training and qualification. “We have only a diploma in midwifery. We can't pursue higher studies because there's no such system in Yemeni universities,” Al-Yareemi says.

She continues, “We hear that a new midwifery department soon will open at Sana'a University to be taught for four years, after which its graduates will have a bachelor's degree in midwifery; however, instruction will be in English, so we won't be able study in this department because we first must study English, as we studied for the midwifery diploma in Arabic at the institute.”

As noted previously, apart from sponsoring the midwives training course, USAID also is providing them financial support to establish their own clinics, according to Amin Ismail Naji, an engineer with USAID's basic health services program, noting that the amount of support will differ according to the number of rooms in a clinic.

As he explains, “Clinics consisting of three rooms will be given $1,000 and those consisting of two rooms will be given $800, while those consisting of only one room will be given $600.”

Naji points out that these funds are to help the midwives either establish or amend their own clinics, adding that such funding will be given to the midwives in three stages in an effort to guarantee that they use it for the intended purpose.