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Waiting in the wings: Nepal’s first midwives set to graduate in 2019
5/7/2018 10:20:57 AM

Kathmandu, 7 May 2018- “I was terribly upset when a woman suffering from heavy bleeding soon after delivering a baby had to be rushed to a hospital travelling six hours on a winding and bumpy road. She was between life and death,” says Pramika Maharjan.

“Luckily, nothing happened to the new mother,” she says, recalling the case she handled in her capacity as a nurse at a health facility in far-western Nepal four years ago. “The case could have been easily treated if I had specific skills to prevent and manage postpartum hemorrhage,” she continues.

And so began her dream of becoming a midwife.

Today, Maharjan is a student of the three-year midwifery course run by the National Academy of Medical Sciences (NAMS). UNFPA, the UN reproductive health and rights agency, is working with the Ministry of Health, Nepal Nursing Council (NNC), Midwifery Society of Nepal (MIDSON) and other partners to help build a competent, well-trained and well-supported midwifery workforce.

Pioneers in Nepali midwifery

The Bachelor in Midwifery program was launched by the Government of Nepal for the first time in January last year, aimed at making midwifery an independent profession by producing skilled midwives.

Kathmandu University (KU) became the second university to start teaching in September 2016. Together, NAMS and KU currently have 29 student midwives.

The first graduates will enter Nepal health system at the end of 2019. “This means the country should now come up with a recruitment, deployment and retention policy of midwives,” says Prof. Kiran Bajracharya, President of MIDSON.

Highly motivated

“It’s sad that many women in our country still suffer from prolonged obstructed labour, haemorrhage, infection, eclampsia etc,” says Shrijana Shrestha, another midwifery student at NAMS. “Most maternal deaths in Nepal are entirely preventable. I am happy that we are gaining specialized skills and knowledge which will help reduce preventable deaths and improve maternal and child health,” she says.

Many parts of rural Nepal still grapple with inaccessibility to health facilities, lack of medical professionals and untrained birth attendants etc. Worse, the majority of them are without gynecologists. As many as 41 percent of babies are still delivered at home and only 58 percent of births are assisted by a skilled provider.

“Everyone in our class is very motivated. We are taught that you are responsible for two lives — a mother and her baby,” says Jeevan Kumari Sah, also a student midwife.

The students have started looking beyond their graduation ceremony. “I want to work in a very remote area of Nepal where pre-pregnancy, antenatal, labor, birth, postpartum and family planning services are scarce,” muses Maharjan.

Their teachers are equally pleased. “They are all devoted students. They consider that to have enrolled into the course is a matter of great pride and a motivation to bring specialized skills to the communities in need of their services,” says Akriti Dahal, a midwifery lecturer.

Midwives key to achieving SDGs

Midwives are key to reducing maternal mortality. Well-trained midwives could help avert roughly two thirds of all maternal and newborn deaths. They could also deliver up to 87 percent of all essential sexual, reproductive, maternal and newborn health services. Nepal has made important progress in reducing maternal mortality from 901 per 100,000 live births in 1990 to 258 in 2015. But there is a long road ahead if Nepal is to achieve its 2030 goal of less than 70 deaths per 100,000.

Preventing maternal and newborn deaths is key to achieving the Sustainable Development Goals by 2030, says Bajracharya. “In the countries that have midwifery education, well-trained midwives have saved lives of women and newborns, thus reducing maternal and infant mortality rates.” 

Attachment: nepal.unfpa.org/en/news/waiting-wings-nepals-first-midwives-set-graduate-2019

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