School of Nursing, Muhimbili University of Health and Allied Sciences, P.O Box 65001 Dar es Salaam, Tanzania.
Tanzania Midwives Association, P.O Box 65524 Dar es Salaam, Tanzania.
Midwifery. 2023 Jul;122:103695. doi: 10.1016/j.midw.2023.103695. Epub 2023 Apr 17.
In Low- and Middle-Income Countries (LMICs), maternal and infant mortality remains a significant problem. Inadequate healthcare provider competencies, including those of midwives, are cited as one of the major contributors to the high maternal and newborn mortality rates. Thus, enhancing the skills of midwives is a prerequisite for enhancing positive maternal and newborn health outcomes. This study describes the lessons learned from a Midwifery Emergencies Skills Training (MEST) project implemented in Tanzania between 2013 and 2018.
An exploratory qualitative study was used to purposefully recruit and interview twelve health facility in-charges and eighteen midwives from twelve selected health facilities in six districts of Tanzania mainland to discover their perceptions about the midwifery practice after MEST training. The data were transcribed verbatim and analysed with qualitative content analysis.
Four categories were generated from the analysis (i) enhanced knowledge and skills in the provision of midwifery care and management of obstetric emergencies, (ii) improved midwives' communication skills, (iii) increased trust and support between midwives and community and (iv) transformed attitudes of midwives toward continued professional development (CPD).
MEST enhanced the knowledge and skills of midwives in the management of obstetric emergencies and referral protocol practice. However, notable gaps remain in the capacity of midwives to provide human rights-based respectful maternity care. Continued professional development for nurses and midwives through training, mentorship and supervision programs is recommended for improving maternal and newborn health.
在中低收入国家（LMICs），孕产妇和婴儿死亡率仍然是一个重大问题。医疗保健提供者能力不足，包括助产士的能力不足，被认为是导致高孕产妇和新生儿死亡率的主要因素之一。因此，提高助产士的技能是改善母婴健康结果的前提。本研究描述了 2013 年至 2018 年在坦桑尼亚实施的助产紧急情况技能培训（MEST）项目中吸取的经验教训。
采用探索性定性研究方法，从坦桑尼亚大陆六个地区的 12 个选定卫生设施中，有针对性地招募和访谈了 12 名卫生设施负责人和 18 名助产士，以了解他们在 MEST 培训后对助产实践的看法。数据逐字转录，并使用定性内容分析进行分析。
分析产生了四个类别：（i）在提供助产护理和处理产科急症管理方面增强了知识和技能，（ii）提高了助产士的沟通技巧，（iii）增加了助产士与社区之间的信任和支持，（iv）改变了助产士对继续专业发展（CPD）的态度。
MEST 增强了助产士在处理产科急症和转诊协议实践方面的知识和技能。然而，助产士在提供基于人权的尊重产妇护理方面的能力仍然存在明显差距。建议通过培训、指导和监督计划，为护士和助产士提供持续的专业发展，以改善母婴健康。
