E-learning for midwives

For midwifery student Mercy Adza-Boon of the Hohoe Midwifery Training school in Ghana, a dream has come true in her final year of midwifery school.

In classes with up to 470 students, it can be difficult for students and tutors to interact and to ensure an optimal learning outcome. But new opportunities have been made available to Mercy and her fellow students.

Midwives save lives; skilled attendance at birth is recognized as a key factor to bring down the number of maternal and new-born deaths in high prevalence countries. In fact, it is estimated that trained midwives could help avert as many as two thirds of maternal and new-born deaths.

But the world lacks midwives – a lot of midwives; as many as 350,000 additional midwives are needed. This translates into a huge need for training of new midwives but also for upgrading the midwifery skills of existing front line workers. In addition, both existing and new cadres of midwives need refresher training to stay updated and adequately skilled.

Therefore, the United Nations Population Fund, UNFPA, has engaged in new partnerships to do things in new ways. A couple of years ago, UNFPA, Intel and Jhpiego teamed up to find an innovative technology driven, low-cost solution to train frontline health workers like midwives and community health workers in key lifesaving skills, family planning and essential new-born care. Sida is the largest donor of the UNFPA Maternal Health Thematic Fund of which the Midwifery Programme is part.

Nine multi-media e-learning modules have been developed on subjects ranging from post-partum haemorrhage, pre-eclampsia /eclampsia – two of the major killers of women during pregnancy and childbirth – to sepsis, family planning, obstructed labour among others. The courses are user friendly and multi-media with built in animations, graphics and latest protocols.

The modules developed by Jhpiego relies predominantly on WHO content. For example their Managing Pregnancy and Childbirth series. The content has been further reviewed by UNFPA and World Health Organization (WHO) technical experts and by major professional bodies including the International Federation of Gynaecology and Obstetrics (FIGO), The International Confederation of Midwives (ICM) and The International Council of Nurses (ICN).

Using the free-of-charge Intel SKOOOL™ platform, the training modules can be accessed anytime, anywhere via low-cost computers or laptops with or without internet connectivity.

Ms. Narki Doku, the Principal at Hohoe Midwifery School is very positive about the potential of the program. “It is often difficult to memorize the textbook definitions of complex clinical procedures as compared to the eLearning versions. Because it’s simple and tells you exactly what to do in any given situation, the student gets a better explanation.”

The modules are innovative, interactive and visual. A content creation toolkit allows countries to create content in local languages and with graphics adapted to suit local social-cultural contexts. This feature secures the relevance of the modules in widely different parts of the world. Built-in assessments help supervisors track the progress of student.

The advantage of the e-modules is, that they can reach front line workers where they are; their skills can be improved on site in the remote, rural areas where women need such support, where giving birth still puts their lives at risk. It has been said about e-health that technology is paving the road to improved outcomes even where few roads exist. UNFPA Executive Director Dr. Babatunde Osotimehin stated that:

“With rapidly proliferating mobile technologies worldwide, and expanding network coverage across the developing world, change is happening faster than anyone could have imagined.”

Results to date have been promising. A pilot on the modules is underway in Bangladesh where the modules are being localized into Bangla. In Ghana, the modules are being used at 6 midwifery training sites where some 1400 students have already supplemented their skills and competency based training using these modules. Another 1800 students have downloaded these modules from the website. UNFPA has further inducted about 500 midwives in the use of these modules. In the coming two years, these modules will be introduced in Tanzania, Zambia and Kenya under the midwifery programme.

The potential of such e-learning to train thousands of additional health care workers and to improve access to refresher training that reinforces right clinical decision-making skills, will ultimately help save many more lives of women giving birth.

Pernille Fenger
Chief, UNFPA Nordic Office