Maternal and Newborn Health Unit, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
Midwifery. 2013 Jul;29(7):e64-72. doi: 10.1016/j.midw.2012.08.009. Epub 2012 Nov 27.
to assess the level, type and content of pre-service education curricula of health workers providing maternity services against the ICM global standards for Midwifery Education and Essential competencies for midwifery practice. We reviewed the quality and relevance of pre-service education curricula of four cadres of health-care providers of maternity care in Northern Nigeria.
we adapted and used the ICM global standards for Midwifery Education and Essential competencies for midwifery practice to design a framework of criteria against which we assessed curricula for pre-service training. We reviewed the pre-service curricula for Nurses, Midwives, Community Health Extension Workers (CHEW) and Junior Community Health Extension Workers (JCHEW) in three states. Criteria against which the curricula were evaluated include: minimum entry requirement, the length of the programme, theory: practice ratio, curriculum model, minimum number of births conducted during training, clinical experience, competencies, maximum number of students allowable and proportion of Maternal, Newborn and Child Health components (MNCH) as part of the total curriculum.
four pre-service education programmes were reviewed; the 3 year basic midwifery, 3 year basic nursing, 3 year Community Health Extension Worker (CHEW) and 2 year Junior Community Health Extension Worker (JCHEW) programme. Findings showed that, none of these four training curricula met all the standards. The basic midwifery curriculum most closely met the standards and competencies set out. The nursing curriculum showed a strong focus on foundations of nursing practice, theories of nursing, public health and maternal newborn and child health. This includes well-defined modules on family health which are undertaken from the first year to the third year of the programme. The CHEW and JCHEW curricula are currently inadequate with regard to training health-care workers to be skilled birth attendants.
although the midwifery curriculum most closely reflects the ICM global standards for Midwifery Education and Essential competencies for midwifery practice, a revision of the competencies and content is required especially as it relates to the first year of training. There is an urgent need to modify the JCHEW and CHEW curricula by increasing the content and clinical hands-on experience of MNCH components of the curricula. Without effecting these changes, it is doubtful that graduates of the CHEW and JCHEW programmes have the requisite competencies needed to function adequately as skilled birth attendants in Health Centres, PHCs and MCHs, without direct supervision of a midwife or medical doctor with midwifery skills.
根据国际助产士联盟（ICM）全球助产教育标准和助产实践基本能力，评估提供产妇服务的卫生工作者的岗前教育课程的水平、类型和内容。我们审查了尼日利亚北部 4 种医护人员提供产妇护理的岗前教育课程的质量和相关性。
我们改编并使用了 ICM 全球助产教育标准和助产实践基本能力，设计了一个标准框架，用以评估岗前培训课程。我们审查了三个州的护士、助产士、社区卫生推广员（CHEW）和初级社区卫生推广员（JCHEW）的岗前课程。评估课程的标准包括：最低入学要求、课程长度、理论与实践比例、课程模式、培训期间进行的最低分娩次数、临床经验、能力、允许的最大学生人数以及母婴和儿童健康（MNCH）部分作为总课程的比例。
审查了 4 个岗前教育课程，分别是为期 3 年的基础助产课程、3 年的基础护理课程、3 年的社区卫生推广员（CHEW）课程和 2 年的初级社区卫生推广员（JCHEW）课程。结果表明，这四个培训课程均未达到所有标准。基础助产课程最接近设定的标准和能力。护理课程则侧重于护理实践基础、护理理论、公共卫生以及母婴和儿童健康。这包括在计划的第一年至第三年进行的家庭健康的明确模块。CHEW 和 JCHEW 课程目前在培训熟练接生人员方面不足。
尽管助产课程最能反映 ICM 全球助产教育标准和助产实践基本能力，但需要修订能力和内容，特别是与第一年培训相关的内容。迫切需要通过增加课程中母婴和儿童健康部分的内容和临床实践经验来修改 JCHEW 和 CHEW 课程。如果不进行这些更改，那么 CHEW 和 JCHEW 课程的毕业生是否具备在没有助产士或具有助产技能的医生直接监督的情况下在卫生中心、初级保健中心和妇幼保健中心充当熟练接生人员的必要能力，令人怀疑。
