Sustaining EmONC training through the Centre of Excellence for Midwifery and Medical Education in Nigeria

Blog 22 Sep 2022
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Right to left Adacha Boslam (LSTM Nigeria Operations manager), Student nurse, Dr Charles Ameh (Programme director LSTM UK), Dr Hauwa Mohammed (Country Director LSTM Nigeria), Khadija Abdullahi (CoE coordinator) and Dr Shama (Lecturer School of Midwifery) at the CoE

A Centre of Excellence (CoE) for Midwifery and Medical Education was launched in the School of Nursing and Midwifery Gwagwalada Abuja, Nigeria. The Centre was established to provide a sustainable system for pre- and in-service training in nursing and midwifery through competency-based Emergency Obstetrics and Newborn Care (EmONC) training. The establishment of the Centre was supported by Johnson and Johnson Foundation in partnership with Liverpool School of Tropical Medicine (LSTM).

The Liverpool School of Tropical Medicine have been implementing a capacity building programme for maternity workers to provide quality care for mothers and newborns in Kwara state Nigeria. The programme has been running since 2015 in partnership with Kwara state ministry of health. This involves competency based EmONC training, Quality Improvement (QI) training and the establishment of EmONC skills rooms.

The skills rooms were set up in 14 high volume facilities across the state. The purpose of the skills rooms was to provide a space for regular competency-based Continuous Medical Education (CME) for maternity staff, training of interns and newly employed or transferred staff to the maternity unit.  

The skills rooms were actively used for a while, however over time they became dormant/non-functional because of transfer of trained staff from the facilities, work overload which made it difficult for staff to find time to use the facility, and there was no particular “incentive” to motivate staff to use the skills rooms. 

The Nursing and Midwifery Council of Nigeria (NMCN) is the regulatory body responsible for regulation of nurses and midwives in Nigeria. Each nurse or midwife is required to renew their practice license every 3 years. Part of the requirement for the renewal is to earn 6 Continuous Professional Development (CPD) points. CPD points are earned through training organized by the NMCN called the Mandatory Continuous Development Programme (MCPDP) where different modules are taught with each module earning 3 CPD points. 

In 2020 a Centre of Excellence for midwifery and Medical Education was established in Kwara state College of Nursing and midwifery. The training was accredited by the NMCN as a module of the MCPDP to provide 3 CDP points which can be used for practice license renewal by nurses and midwives. 

The CoE in Kwara state was a success, nurses and midwives register for the training through the normal channel for NMCN MCPDP programme, they are trained in EmONC and gain 3 CPD points which they can use for license renewal. The attachment of the CPD points to the training has created a demand for the training as this is an “incentive” to make the health workers want to access the training. The advantage of this system is that it fits into an already existing system and completely run by the NMCN Kwara state which will ensure sustainability. The Centre is also used for pre-service education of nurses and midwives in the school.

EmONC training in the CoE Kwara state

Following the success of the Kwara state CoE, a new CoE in the School of Nursing and Midwifery Gwagwalada Abuja was set up. The school is the only training institution for nursing and midwifery in Abuja, it is also the venue for all MCPDP training organized by the NMCN Abuja chapter. The advantage of having the CoE in the School is that there are students in both basic nursing and midwifery as well as post-basic midwifery who can be taught in the Centre. The school is also adjacent to the University of Abuja Teaching Hospital where interns and residents are trained, they can all access and utilize the Centre for training. 

Auditorium refurbished and furnished CoE Gwagwalada

The School auditorium was the designated site for the CoE, it was refurbished and equipped to function appropriately. A separate room attached to the auditorium was fitted for storage of the training equipment.

Sample of a break-out room at the CoE Gwagwalada

A full set of training equipment for competency based EmONC training which includes low and high-fidelity mannequins for simulations, instruments for surgical procedures, some consumables, storage containers for the equipment etc. were supplied to the Centre. An LSTM trained coordinator for the Centre was appointed from the School. 

LSTM country director showing the training equipment at the launch of the CoE Gwagwalada

 

The Centre was officially launched on 22nd August 2022, with the Director Nursing Services (DNS) Abuja, representative of NMCN, principals of schools of nursing and midwifery Gwagwalada, master trainers, student nurses and midwives and the DNS from Kwara state attending the event. 

The Centre was created for the purpose of providing a sustainable system for CPD for nurses and midwives both in pre- and in-service training as well as a Centre where other health professionals can access their own CME programmes. Training for nurses and midwives in competency based EmONC training as part of their MCPDP training will be done in the Centre to earn 3 CPD points that can be used towards license renewal. 

The representative of the NMCN at the launch said “The NMCN is pleased to partner with LSTM and are happy to continue the partnership because of the success of the CoE in Kwara state.” 

Immediately after the launch the NMCN Abuja in partnership with LSTM organized MCPDP training for 30 nurses and midwives in the new Centre. They all earned 3 CPD points for the training. 

Dr Charles Ameh, Head of the LSTM Emergency Obstetric Care and Quality of Care implementation research group said “Sustainable solutions to improve the quality of skilled health personnel to support pregnancy and childbirth is the way to go if we are to achieve national and international MNH targets”.