GLOBAL REPORT

The Canadian Association of Midwives (CAM) believes that midwives play a unique and fundamental role in the provision of quality reproductive, maternal, and newborn health care – both in Canada, and internationally.

Since 2008, the CAM has been working through partnerships with other national midwifery associations to deliver reciprocal capacity building and project development initiatives.

In 2021, three projects (SMSII, MBM and ISDSM) came to an end while CAM Global added two new projects to its portfolio, PASSREL and SMART-RMC.

STRENGTHENING MIDWIFERY SERVICES IN SOUTH SUDAN PHASE 2 (SMSII)

SMSII  (2016-21) aimed to increase the availability of skilled health care providers, especially midwives, in order to reduce maternal and infant mortality in South Sudan. SMSII is a collaboration between CAM and the South Sudan Nurses and Midwives Association (SSNAMA) to improve health outcomes and gender equality across the country through midwifery education and association strengthening.

SMSII was a UNFPA-led project supported by the South Sudan Ministry of Health and funded by the governments of Canada and Sweden.

 

Highlights

  • 25 medical instructors were trained on how to teach physician & surgical students on Emergency Surgical Skills for General Surgery and Obstetrics. (2020-21)
  • 28 physician & surgical students trained on Emergency Surgical Skills for General Surgery and Obstetrics. (2020-21)
  • 15 Communications trainings were given with over to over 15 members of SSNAMA, NAMCOSS and Ministry of Health
  • Operations Research was conducted in 12 health facilities in South Sudan with the goal of offering recommendations on improving the internal structural
  • National Mentorship Guidelines developed
  • SMSII Tutor manual distributed to approximately 100 educators and tutors. 265 students have graduated and 169 are currently enrolled in Diploma in Midwifery.
  • 21 students are enrolled in Diploma in Health Personnel Education
  • Creation of Family Planning Tool Kit for midwives providing family planning information sessions in clinics, homes and in public spaces in South Sudan. The tool kit also consists of a discreet take-home booklet. Over 100 manuals were distributed and over 1000 take home booklets.
  • Intro to Communication handbooks and website training manuals developed

The SMSII project ended in 2021. Here are just a few examples of how CAM, together with the South Sudan Nurses and Midwives Association (SSNAMA) and other stakeholders contributed to strengthening midwifery in South Sudan:

  • Successful implementation of a Peer-to-Peer Mentorship Program which provides the opportunity for peer exchanges between Canadian and South Sudanese midwives. Over 1000 exchanges on topics such as Hepatitis B, HIV/AIDS, hypertension, retained placenta, shoulder dystocia, breech deliveries, sexual violence, menstruation difficulties, preeclampsia, and obstructed labour have been recorded.
  • Continuing Professional Development Portal was created for midwives and nurses and features information and trainings related to prenatal, intrapartum, and postnatal care. For more information: https://namcoss.org/cpd-portal/
  • In the Classroom – courses on subjects such as Teaching and Learning Principles, Curriculum Development, Teaching and Learning Resources, Research Proposal, and Data Analysis were developed, and research was conducted on important health and social issues in South Sudan.

“…the fundamentals of midwifery are the same—empowering women, supporting reproductive justice, facilitating safe birth and newborn care, and advocating for gender equity. It is the local challenges that are different and one of the biggest ones is access to resources, including human resources. It is too often assumed that health care workers who practice in high resource countries have greater skills than those in lower resource areas. The Peer-to-Peer program has highlighted that this is not the case. The South Sudanese midwives are dealing with cases daily that I may see only once or twice in my career in Canada.” – Shannon Kaupp (RM & coordinator of the Peer-to-Peer program)

VOICE, CHOICE, CHANGE

The 2019 documentary Voice, Choice, Change: The Lives of Midwives showcased the lives and roles of two South Sudanese and two Canadian midwives.

  • As of September 2021, it has seen by approximately 5,000 people in person and has over 100,000 views online. 1800 likes — 50 comments—52 shares

LABOUR PAINS

Labour Pains Animated Film

The 8minute animated film Labour Pains, based on the true story of a young midwife using her training and ingenuity to save the life of a mother from a post-partum hemorrhage, has been screened in nine international film festivals (including Canada, USA, Tanzania, South Africa, Zambia). The film is being used as an advocacy tool to promote the importance and value of midwives in the health care system.

  • Labour Pains animated film has had 18,000 views online to date.

MIDWIVES ALWAYS HAVE SONGS

A series of public engagement pieces created to promote the collaboration between midwives in Canada and South Sudan as part of the SMSII project.  They include a magazine, a series of short videos, social media posts and a web-documentary.

  • The pieces have been shared on social media and have been viewed more than 225,000 times.

For information: www.midwifesongs.org

YOUTH ADVOCACY IN SOUTH SUDAN

In 2020-21 CAM, under the guidance of the South Sudan Ministry of Health and UNFPA, with the support of the WHO, UNICEF and other NGOs, and in partnership with The South Sudan Nurses and Midwives Association and Shabab La Shabab youth network, CAM created Zone 72. Zone72 is a national strategy addressing the challenges facing youth, in particular high levels of unwanted pregnancy, gender-based violence, ending child marriage and social sustainability in South Sudan. The campaign advocated for more youth involvement in decision making, youth-led advocacy and equal access to health and education for girls.

  • 2500 followers on Zone 72 Facebook
  • Over 1000+ questions and comments on FB, email and WhatsApp
  • 16,000 youth IEC materials disseminated (3 SRHR magazines, 2 comic books, SRHR pocket books, 10 short radio dramas)
  • 30,000+ estimated listeners weekly of the Zone72 weekly talk show, with over 300+ logged calls and text messages.

SMSII ASSOCIATION STRENGTHENING

1,368 qualified nurses and midwives joined the association between 2016–2020. 9 continued professional development workshops organized by South Sudan Nurses and Midwives Association (SSNAMA) staff for its members, covering topics such as clinical communication skills, adolescent sexual and reproductive health, and rights, COVID-19 infection prevention and control, and respectful maternity care.

VOCATIONS SKILLS DEVELOPMENT FOR A SUSTAINABLE SOUTH SUDAN NURSES AND MIDWIVES ASSOCIATION

In partnership with the Vocational Skills Development Organization of South Sudan, South Sudan Nurses and Midwives (SSNAMA) established 7 income-generating activities for SSNAMA across the country, including pharmacies and restaurants. Submission of 5 funding proposals by SSNAMA to increase their programming reach and financial stability. Canadian midwives raised over $5000 CAD in 2020 to support the start-ups.

 

SMART RMC

Through the provision of gender-responsive, quality health care by a well-trained midwifery workforce, the SMART-RMC project aims to contribute to the reduction of maternal deaths in both the DRC and South Sudan.

Key project activities will be grounded in Respectful Maternity Care (RMC), and will focus on improving clinical services through:

  1. training health care providers in evidence-based innovations using a gender-responsive rights-based approach
  2. increasing women’s and communities’ awareness of their SRHR to access health services
  3. strengthening the capacity of midwifery associations to deliver gender-responsive programming and SRHR advocacy.

This CAM led 3-year project, supported by the Government of Canada through Global Affairs Canada, is implemented by CAM in close collaboration with its project partners, the Société Congolaise de la pratique Sage-Femme (SCOSAF: the midwifery association of DRC) and the South Sudan Nurses and Midwives Association (SSNAMA).

SAJ FANM POU FANM

The 5-year SFF Project (2018-2022) aims to reduce maternal mortality by strengthening the midwifery profession and practice and promoting the health and wellbeing of women, girls and newborns in Haiti. of  the United Nations Population Fund (UNFPA), in collaboration with Canadian Association of Midwives (CAM)Association des infirmières sages‑femmes en Haïti (AISFH) Université du Québec à Trois‑Rivières (UQTR), the Institut de Formation des Sages-Femmes (INSFSF), and the Ministère de la Santé Publique et de la Population (MSPP). The project is financially supported by the Government of Canada through Global Affairs Canada.

Highlights 2021

  • The technical clinical and teaching skills of a pool of 16 instructor-midwives were strengthened in the Formation en urgences obstétricales (FUO)
  • A total of 85 health care providers were trained by the FUO instructors
  • The Safe Delivery App was introduced into the FUO, which was rolled out into health care facilities as a workplace resource to support continued learning of health care providers. Approximately 400 health care providers are now using the app to support their learning in Haiti.

Photo Expo: Haïti

ALO SAJ FANM TELEPHONE HOTLINE

Alo Saj Fanm Telephone Hotline is a free telephone service offered 24-hours a day, seven days a week to people in Haiti. A collaboration between l’Association des infirmières sages‑femmes d’Haïti (AISFH), UNFPA and CAM, and funded by Global Affairs Canada, the telephone line features the option of listening to pre-recorded information regarding maternal and child health and SRHR or speaking with a midwife live. This telephone service is designed to fill in the gaps in Haiti’s vulnerable health system, where most mothers do not have access to any health care, especially in remote areas.

 

  • The hotline has received more than 12,000 calls since its launch in September 2020.
  • Over 750+ have registered for push notifications featuring information on prenatal and antenatal health, appointment reminders and more

For further Information about Alo Saj Fanm https://cam-global.org/2020/12/04/alo-saj-fanm-call-centre/

 

 

About the health system in Haiti

“My sister lives in an area of Haiti where she cannot even access a doctor. She sees a Matrone. If anything happens, the matrone cannot help her. If something happens during her birth, my sister knows she might die.”

PROJET D’APPUI A LA SANTE SEXUELLE ET REPRODUCTIVE EGALITAIRE (PASSEREL)

Launched in April 2021, the Supporting Equal Sexual and Reproductive Health (SESRH) Project, funded by Global Affairs Canada (MAC) and implemented by the Fondation Paul Gérin-Lajoie, the Canadian Association of Midwives (CAM) and the Society of Obstetricians and Gynaecologists of Canada (SOGC) The ultimate goal of the project is to improve the enjoyment of the right to health, particularly sexual and reproductive health and rights (SRHR), by 55,346 citizens (40,755 adolescents/women and 14,591 adolescents/men) in the municipality of Croix-des-Bouquets.

MORE AND BETTER MIDWIVES FOR RURAL TANZANIA

  • The 5-year MBM Project (2016-2021) aimed to improve the health and well-being of women and children in the Lake and Western Zones by addressing the shortage of skilled midwives as a means to contribute to the reduction of preventable maternal and newborn mortality. The project provided a forum for TAMA to advocate with the Tanzania Nursing and Midwifery Council (TNMC) for regulation and licensure processes that adhere to global standards and reflect the priorities of Tanzania’s midwives.The project was implemented by a consortium led by Jhpiego in partnership with Amref Health Africa-Canada and the Canadian Association of Midwives (CAM) and financially supported by the Government of Canada through Global Affairs Canada.Highlights
    • TAMA increased the number of functional branches from four (122 members) to 10 (431 members) This is expected to increase the continued advocacy and promotion of midwifery profession within Tanzania.
    • 2 position statement papers were developed and disseminated to the government as an advocacy method to influence health policies entitled “Respectful maternity care” and “Competent midwives for quality maternal, newborn and child health”.
    • A mentorship programme was developed, and 89 practicing senior midwives were trained on mentorship skills to mentor students and fellow practicing midwives. By the end of the project, a total of 3,759 mentorship sessions had been conducted by midwifery mentors.
    • 95% of pre-service health training institutes achieved 85% of CQI standards (19/20 institutes, up from 6/20) (CQI=continuous quality improvement)
    • 100% of in-services training sites achieved 80% of SBM-R (19/19 sites, up from 0/19) (SBM-R=Standard-based management and recognition)

IMPROVED SERVICE DELIVERY FOR SAFE MOTHERHOOD PROJECT

Improved Service Delivery for Safe Motherhood Project: Strengthening & Supporting Midwifery in Tanzania (ISDSM) (2016-21) was a collaboration between CAM (The Canadian Association of Midwives) and TAMA (The Tanzania Midwives Association) was a six year project that addressed the need to maternal health service delivery in six targeted districts across Tanzania. The project, funded by the Sanofi-Espoir Foundation specifically targeted geographically disadvantaged areas that face limited access to emergency obstetric care and shortages of adequately skilled maternity health care providers.

  • 65% reduction in maternal mortality in selected project facilities from 345/100,000 livebirths in 2014 to 117 per 100,000 livebirths in 2019
  • 40% reduction in neonatal mortality in selected project facilities from 13.5/1000 livebirths in 2014 to 7.9/1000 live births in 201

STRENGTHENING MIDWIFERY EDUCATION AND PRACTICE IN SOMALIA & SOMALILAND (SMEPS)

SMEPS (2020-2024) aims to reduce maternal mortality by addressing the critical shortage of skilled midwives through enhancement of midwifery education and practice, regulation and association strengthening. The project works in Somalia, Puntland and Somaliland.

Overall, the project consists of:

  • improving midwifery education by strengthening clinical skills, knowledge and practice of pre-and in-service midwives.
  • promoting community advocacy by positively influencing gender equality norms concerning GBV, SRHR, consent and access to health care.
  • developing midwifery leadership in the health sector by empowering professional midwifery associations in the Somali region.
  • improving the ability of the MoH to manage and regulate midwifery education and practice, recognizing midwives’ associations’ technical expertise in the profession.
  • utilizing technologies in mHealth to increase communities’ access to health care information.

SMEPS is a United Nations Population Fund (UNFPA)‑led collaboration between: Canadian Association of Midwives (CAM), the Somali Midwifery Association (SOMA), the Somaliland Nurses and Midwifery Association (SLNMA) and the Puntland Association of Midwives (PAM). It is supported by the Government of Canada through Global Affairs Canada.

Highlights

In 2020-21, the project conducted:

  • 3 MACAT (Member Association Capacity Assessment Tool) trainings
  • 3 curriculum revision workshops
  • 3 communication advocacy trainings
  • 3 SRHR campaigns within targeted communities by the midwives’ associations
  • 2 midwifery regulation assessments
  • 2 midwifery education and practice assessments
  • 2 organisational development capacity trainings
  • 2 “Foundations of midwifery regulation” workshops

The development of the SRHR mobile app for Somali youth was also initiated this year. Throughout next year CAM will be working closely with Somali youth and a mobile app developer to create this product as a way to support increased knowledge of sexual health and reproductive rights.