Canadian midwife consultants Sarilyn Zimmerman and Basak Ardalani recently returned from a 5-day trip to Juba, South Sudan, where the Canadian Association of Midwives (CAM) and the UN Population Fund (UNFPA) are collaborating, in partnership with South Sudan’s Ministry of Health, to implement the second phase of the Strengthening Midwifery Services in South Sudan (SMS II) project.
South Sudan has among the world’s highest maternal, newborn and child mortality rates, due in part to the critical shortage of skilled health care providers. By increasing capacity building initiatives for midwives and other health care providers, CAM and its partners hope to reduce the number of mothers and newborn babies who die every year in South Sudan. This five-year project (2016-2020) is being funded by the Government of Canada, through Global Affairs Canada, and the Swedish International Development Agency (SIDA). One part of this project is the development of a Clinical Procedures Manual, being carried out by Canadian midwives Sarilyn Zimmerman and Basak Ardalani in collaboration with UNFPA and the midwifery stakeholders.
For the Canadian consultants, work started months earlier as they worked remotely with the UNFPA and stakeholders in Juba to develop an outline of content for the manual and brainstorm creative practical aids for users of the manual. The goal was to not only create the manual, but also tip sheets and teaching aids that midwives could easily carry with them. The manual is geared to be a teaching tool and skill refresher for all levels: students, tutors, midwives and traditional birth attendants.
Sarilyn Zimmerman explains that the plan going forward was to “decide on potential relevant clinical topics together and then produce a draft of two topics”. The objective of the Canadian midwife consultants’ trip to Juba was to review with the stakeholders the drafts of the two selected topics: ‘Active Management of Third Stage of Labour’ and ‘Breech Management and Delivery’. “Basak and I would present the drafts in workshops in Juba for feedback from those who were going to use it as a teaching tool, an update and a skills refresher.” This feedback would then be used to model the other topics.
Despite a limited timeframe, both consultants were able to meet with various key groups, introduce the drafts, conduct a review and receive feedback. They also had the opportunity to observe first hand where the midwives studied and worked. “We wanted to get a sense of what it was like to be a midwife in South Sudan considering resources and the barriers they faced which currently include war, famine and lack of funds.”
“We saw twins being breastfed, a midwife rubbing a labouring woman’s back and another assisting a newborn to the breast, labouring women, their families and little children walking in the hallways, food being cooked outside the hospital and midwives providing care.”
– Sarilyn Zimmerman
Understanding the resources available in various settings was essential to ensuring that the consultants will be able to develop an appropriate Clinical Procedures Manual and learning tools. “From our four workshops, we now have a clearer idea of what is wanted in the manual: what topics would be most important to them, how they would like the topics presented and their desire for an accessible and practical guide with diagrams and information posters.”