Jhpiego helps train next generation of midwives in Myanmar

In Myanmar, a new generation of skilled midwives is gearing up to protect the lives of their countrywomen.

Image caption: A tutor at the Pyay midwifery school mentors students during a simulated birth in a clinical skills lab set up by Jhpiego. The clinical skills lab allows students hands-on practice and experience with birth and newborn resuscitation simulators.

Image credit: Ann LoLordo

Each year, an estimated 3,700 women die during childbirth in Myanmar, and 43 percent of women who give birth there do so without skilled assistance. The Myanmar Ministry of Health is leading the way, with support from Jhpiego, to strengthen midwifery education through hands-on practice and equip frontline health workers with the skills to keep mothers and newborns alive.

Jhpiego, a nonprofit global health affiliate of Johns Hopkins University, is working with 24 midwifery schools to increase the number and quality of faculty and students and to improve the clinical practice facilities where they teach and study.

Midwives of the future

Aye Thazin Pwint is the future of midwifery in Myanmar. A first-year student at the Midwifery and Training School in Pyay, Pwint is among the hundreds of students and working midwives throughout Myanmar learning new skills and procedures as the country opens its doors to new partnerships with the world.

"I didn't know anything about the birth process aside from what I learned in books," said Pwint. "Now we are more skilled because we have to practice again and again [in a refurbished skills lab]. And because we are more skilled, we have more confidence in what we do."

One of Pwint's instructors recognizes the leap forward that this new initiative represents.

"When I was a student, I was very afraid to encounter a pregnant mother for a delivery. In this new skills lab, the simulators are very real," Tin Ma Ma Nyein said. "This will increase the confidence of my students."

Teaching aids provided through the project simulate real birth and newborn care, giving students like Pwint practical, hands-on experience.

"The students can practice more, operate more systematically, and improve their performance," said Khin Moh Moh Oo, principal of the Nursing and Midwifery Training School in Pyay. "I believe this can help reduce maternal and child mortality rates in Myanmar."

To help ensure high-quality care, Jhpiego is also working with the Myanmar Nurse and Midwife Council to develop a robust regulatory system. Developing and publishing core competencies, standards, and a code of ethics for midwifery, as well as accreditation guidelines for nursing and midwifery education programs, are critical components of ensuring the strength of Myanmar's health system for mothers and children.

Training midwife mentors and improving facilities

With support from the Three Millennium Development Goal Fund, Jhpiego has trained 68 faculty "master mentors" at Myanmar's midwifery schools who serve as the best and brightest teachers and role models. In addition, 165 faculty members and service providers have been trained in best practices in maternal and newborn care. Jhpiego has also implemented new equipment and procedures in 10 skills labs for midwifery training, with another 14 labs and 22 clinical practicum sites to be similarly outfitted this year.

The Ministry of Health's effort to strengthen midwifery care across Myanmar has attracted investment from key international partners:

• Support from the GE Foundation enables the Ministry of Health to benefit from strengthened midwifery services at its largest women's hospital in Yangon, which is also an important teaching institution.

• Jhpiego, through funding from Merck for Mothers, is working on a midwifery education and training model specifically for midwives and auxiliary midwives in Kayin State. This program has been carefully designed, in collaboration with the Ministry of Health, to strengthen the skills of health care workers at the lower levels of the health system—ensuring that no midwife is left behind.

• Through the United States Agency for International Development's Maternal and Child Survival Program, Jhpiego is assisting in the development of a system to help ensure that Myanmar's midwives receive the necessary in-service training and continuing professional education after they are licensed to practice.