INTRODUCTION

THE C.M.W MODEL





INDICATORS


Hemcom Bandages

 

 

 

Community Based Skilled Birth Attendants

 

 

 
An important reason for high maternal mortality in Pakistan and generally in the developing countries is the use of unskilled birth attendants such as family members and traditional birth attendants. The proposed project will introduce a cadre of community-based health workers, who will meet the international definition of skilled birth attendants. These community midwives (CMWs) will be trained in home-based deliveries, which will significantly increase the proportion of skilled birth attendance in the country.

 

 

   

The Community Midwives are specially trained Skilled Birth Attendants who are equipped to conduct a normal home delivery under safe and clean conditions.
The CMW model includes the following functions:

  • Providing individualized care to the pregnant women throughout the maternity cycle and the newborn, in her own environment and helping her in self-care.
  • Monitoring the physical, social and emotional well-being of the pregnant woman as needed.
  • Taking appropriate action within the resources available.
  • Providing guidance and counseling to the community for healthy habits, and involving the family in preparation for childbirth and for unforeseen emergencies.
  • Identifying actual or anticipated conditions requiring medical attention and making timely referrals.
Practicing midwifery within the legal framework and following the professional code of conduct provided by the relevant authority.

The CMW model

The CMW model includes the following functions:

  • Providing individualized care to the pregnant women throughout the maternity cycle and the newborn, in her own environment and helping her in self-care.
  • Monitoring the physical, social and emotional well being of the pregnant woman as needed.
  • Taking appropriate action within the resources available.
  • Providing guidance and counseling to the community for healthy habits, and involving the family in preparation for childbirth and for unforeseen emergencies.
  • Identifying actual or anticipated conditions requiring medical attention and making timely referrals.
  • Practicing midwifery within the legal framework and following the professional code of conduct provided by the relevant authority.

Objectives of the Implementation

  • To strengthen the existing midwifery and LHV training schools in the country through development of linkages with DHQ and THQ hospitals for practical training, renovation of existing facilities and creation of domiciliary midwifery linkages.
  • To improve the quality of midwifery training in the country through implementation of a standardized curriculum approved by the Pakistan Nursing Council, training and deployment of specific midwifery tutors and provision of standard training aids.
  • To train a core group of master trainers at the National level for the training of midwifery tutors.
  • To train 600 midwifery tutors all over Pakistan on the new curriculum for training of community midwives.
  • To recruit, train and deploy 12,000 community midwives in the community by the end of the fourth year of the project.
  • To promote birth preparedness activities through counseling.
  • To strengthen the registration and accreditation system of the Pakistan Nursing Council through supporting additional staff for quality assurance and monitoring of trainings.
  • Development of a computerized database of midwives at provincial MNCH directorates.

Expected Outcomes:

The proposed network of community midwives at the grass root level would play a pivotal role in achieving the following:

  • Increasing the proportion of skilled birth attendants will have a definite impact on reducing maternal and newborn mortality and morbidity through:
  • Establishing linkages, conducting normal deliveries at the household level and is able to recognize complications and takes decision of in-time referrals of complicated obstetric cases to the higher level of functional health facilities.
  • Delivery of quality RH-PHC services at the community level.
  • Established community midwifery schools with regards to human resource and equipment, thus providing a continuum of technical back stopping to the skilled birth attendants.
  • LHWs Support provided through a regular contact with the SBAs would be established by the National Program for Family Planning and Primary Health Care through the LHWs supervisors.
  • Including a socio-culture change in the communities by counteracting the misinformation based on taboos and negative traditional practices.
  • Provide opportunities for gender development and income generation thus helping poverty alleviation.
  • Gradual replacement of TBAs by trained community midwives.

Trainings of Community Midwives

To achieve the target of placement of approximately 12,000 CMWs, it will be necessary to enroll minimally 20% more to cater for dropouts and failures. To this end it is proposed to enhance the training capacity of already existing midwifery training units at district level and to identify new midwifery-training units at district and tehsil level hospital where there are none. Most of the districts already have these institutions, which need to be expanded, made functionally more efficient and ensuring quality practical training through training of cadre of provincial master trainers for community midwifery that would further play a facilitative role of training district level trainers in the province.
The identification of potential training sites and bringing them at par with the required level outlined by the Pakistan Nursing Council will require up-gradation of the already existing training units would require inputs in the shape of teaching equipment, furniture, library facilities, training of trainers etc.

Selection Criteria

The community midwives shall be selected only from the rural areas. The selection criteria may be summarized as follows:-

  • Female, preferably married.
  • Permanent resident of the area, for which she is applying.
  • Minimum qualification should be at least Matric preferably with Science subjects obtaining 45% marks
  • Have experience of working in the community
  • Should be 18 – 35 years of age

 

Community Midwives Schools (2006 - 2010)

Chart.

 

Community Midwives (2006 - 2010)

 

 

CMW Kit

C M W .. K I T .. I T E M S
UNITS
Equipment  
Fetoscope 
1
BP Apparatus mercury Desk Type 
1
Stethoscope 
1
Weighing machine adult  
1
Baby weighing machine  
1
Measuring tape  
2
Sterilizer (electric 12x 16)  
1
Equipment required for episiotomies 
1
Disposable Delivery Kit.  
50
Medicine
Micronutrients 
80
Antibiotics  
80
Analgesics  
Antiseptics 
2
Injections required for delivery  
20
Antifungal Vaginal Tablets with applicator
6
Contraceptives       
Sign Board  
1
KIT box Steel 
1
Stationery items
Partograph chart 
100
Health Education material     
Data recording and reporting instruments       

 

Hemcom Bandages

Hemcom Bandages have been received from Ministry of Health. They are being distributed in 95 Nursing Schools across Pakistan. To view the details of distribution, please Click Here