Filmed and produced by Felicity Copeland and post-production by Clancy Weatherald
WHO CC involvement: Prof Caroline Homer, Michele Rumsey, Alison Moores, Amanda Neill, Prof Pat Brodie, Dr Angela Dawson
The Maternal and Child Health Initiative (MCHI) in Papua New Guinea (PNG) was a multi-stakeholder Initiative that commenced in 2012 and concluded its contract in 2015. It was led by the PNG National Department of Health in collaboration with the WHO CC UTS with Professor Caroline Homer as the Initiative Director, and funded by the Australian Government. The World Health Organization PNG provided technical support and advice. Through improvements to the standard of midwifery clinical teaching and practice in the five midwifery schools in PNG, and the quality of obstetric care in two regions of PNG, the aim of the Initiative was to make a positive impact on PNG’s high rates of maternal and newborn death.
Ten clinical midwifery facilitators (CMFs) were placed in the four existing midwifery schools, and one new midwifery school that commenced its program in the second half of 2015, to support PNG clinical midwifery educators through mentoring, capacity building and development. A Clinical Midwifery Educator (CME) was also placed in the Maternity Unit of Port Moresby General Hospital in 2015 to provide professional development for clinical staff, assist with quality improvement and to support the PNG Midwifery Society. The CMFs and CME worked closely with academic and clinical personnel in the midwifery schools and hospitals to support capacity-building of educators, clinical supervisors, and preceptors, through supportive mentoring, clinical supervision and role modelling. They also worked closely with clinicians to enhance midwifery education and practice. Throughout the process, peer support, mentoring, and the provision of relevant evidence-based educational and practice materials has been provided, while working side by side with designated national midwifery counterparts and other health care workers.
Two obstetricians were placed in regional hospitals. WHO CC UTS undertook the role of organisation of workshops, support for ongoing regulation and registration processes, and to provide support to midwifery educators and course coordinators recruiting MCHI staff (CMFs and obstetricians), provided mentoring, support and capacity building to the MCHI team and their counterparts, and monitoring and evaluation of the Initiative.
Through three education and capacity building workshops per year, the MCHI brought together different stakeholders working to build capacity and improve maternal health outcomes in PNG, specifically national midwifery educators, obstetricians, course coordinators, clinicians and CMFs.
The WHO Collaborating Centre at UTS has provided recruitment and employment, mentoring and support and also monitoring and evaluation for the Initiative during this time. One to one and group mentoring and support to the MCHI team was provided by Adjunct Professor Pat Brodie and Ms Alison Moores.
In 2015, the WHO UTS CC continued extensive Monitoring and Evaluation of the MCHI, collecting data from:
- Over 30 interviews with stakeholders including PNG educators, obstetricians, clinicians, students and NDoH staff
- 3 focus groups, each with 22 participants (including course coordinators, CMFs and MCHI obstetricians) each
- Monitoring reports collected from each midwifery school every four months
- Rural reports were also completed by each midwifery school following rural placements – one comprehensive report each year.
Monitoring and evaluation work has been led by Amanda Neill, Project Manager WHO CC UTS. Longer-term evaluations will need to address changes in the rate of skilled birth attendants, maternal mortality ratio and rates of neonatal mortality and stillbirth.
The first two years (Phase One - 2012 to 2013) contributed to increasing the quality of midwifery education in PNG and more midwives graduating in these two years than the previous decade.
Phase Two (2014 to 2015) saw the continuation of this work - incorporating lessons learned through monitoring and evaluation of Phase One, while strengthening successful strategies already in place.
As of the end of 2015, 451 midwives have graduated, and 129 midwifery students are soon to graduate from the 2015 program. There are also 402 midwives registered in Papua New Guinea in 2015 compared to the 152 in 2012.
It is hoped that the provision of mentoring, evidence-based educational and practice materials and continuous competency development and capacity building for national obstetricians and midwives will continue to increase the number and skills of graduates and improve the quality of services being delivered.
The Initiative will continue to have, a positive impact on PNG’s high rates of maternal and child death through improvements to the standard of midwifery clinical teaching and practice in four midwifery schools in PNG, and the quality of obstetric care in two regions of PNG.
Stakeholder Forum for the end of the Initiative
The Maternal and Child Health Initiative (MCHI) Stakeholder Forum was held at the Holiday Inn, Port Moresby, Papua New Guinea (PNG) on Wednesday 25 November 2015. The Forum brought various stakeholders together to conclude the Initiative and reflect on the achievements and challenges of the MCHI over the past four years and consider the way forward for midwifery education in PNG.
Over 50 stakeholders attended the Forum with representation from NDoH, WHO PNG, Australian Department of Foreign Affairs and Trade (DFAT), Australia Awards, Deans/Heads of Schools, Church Health Services, Susu Mamas, Reproductive Health Training Unit (RHTU), national midwifery course coordinators, midwifery educators, clinicians and the MCHI obstetricians, clinical midwifery educator (CME) and clinical midwifery facilitators (CMFs). The Forum was officially opened after an opening prayer by MCHI key stakeholder Ms Mary Killilo - Technical Advisor Pre-service and Health Training, NDoH.
Presentations followed from Dr Lahui Geita, Technical Advisor Family Health Services, NDoH; Professor Caroline Homer who gave an overview of the real and potential impact of strengthening midwifery in PNG and globally; Professor Pat Brodie AM who summarised the development of the MCHI, its design and implementation. Professor Mola followed with an informative talk on increasing obstetric care in PNG regions; Mrs Jennifer Pyakalia and Ms Ann Yates spoke about strengthening the PNG Midwifery Society; Ms Amanda Neill summarised key findings from the MCHI monitoring and evaluation work; Ms Alison Moores, Mrs Paula Puawe and Dr Nancy Buasi then presented an overview of progress of the Midwifery Graduate Study.
Key achievements in midwifery regulation were reported on by Dr Nina Joseph from the PNG Nursing Council, and Ms Michele Rumsey from the WHO Collaborating Centre at UTS. The course coordinators from each of the five midwifery schools also gave short 10 minute presentations focussing on strengthening midwifery that included stories illustrating their midwifery education experiences. Ms Christine Sturrock presented on the Australian Government’s support for the PNG health workforce and the Forum concluded with discussions on the way forward. Attendees at the forum had an opportunity to share knowledge and information on the MCHI and the way forward. They also had the chance to discuss outstanding issues for the future of midwifery education, and look at ways to continue to develop the PNG midwifery workforce and ensure quality midwifery care. This was the final workshop activity for Phase II of the MCHI. The final Steering Committee meeting was held on Friday 27 November which marks the end of the workshops and meetings for MCHI Phase II. The MCHI officially finishes on 31 December 2015.
PNG Midwifery Society's Symposium
The PNG Midwifery Society’s Symposium preceded the Stakeholder Forum, held from 23-24 November. Over 260 midwives attended this inaugural event which was deemed a great success for the midwives of PNG. The MCHI has provided ongoing support of the PNG Midwifery Society, through the work of the CME and supported by the CMFs. More than 260 delegates attended the Symposium. It was an amazing two days of learning and sharing with incredible energy and enthusiasm. The symposium showed that the PNG Midwifery Society is a vibrant and important association that has real capacity to make a big difference to maternal and child health in PNG.
PNG Maternal and Child Health Initiative (MCHI) Workshop
WHO CC involvement: Prof Caroline Homer, Amanda Neill, Alison Moores
MCHI briefs
Scaling up midwifery in PNG (PDF, 2MB)
Midwifery graduates in PNG (PDF, 1.4MB)
MCHI phase 1 key achievements (PDF, 1.3MB)
Health system strengthening in PNG (PDF, 1.2MB)
Midwifery capacity building (PDF, 1MB)
Midwifery education discussion paper (PDF, 1.3MB)
Midwifery partnerships literature review (PDF, 1.3MB)
Motivation to be a midwife in PNG (PDF, 1.2MB)
MCHI phase 2 stakeholder forum brief Nov 2015 (PDF, 300KB)
MCHI phase 2 workshop one 2015 March brief (PDF, 600KB)
MCHI phase 2 workshop two 2015 Sept brief (PDF, 400KB)
MCHI phase 2 reports
MCHI phase 2 M and E mid-term report April 2015 (PDF, 900KB)
PNG MCHI Phase II M and E Final Report June 2016 (2).pdf (PDF, 1.3MB)