Joint Annual Performance Review 2007 - Ministry of Health

Results: Competency (7)
• It appears that there is wide variation in the content of the
continuing education courses held in peripheral sites, and it
was difficult to assess their effect. Numbers were too small
to look at the effect of any of the other competencies in
these short in-service courses. For this reason we
compared competencies of midwives who attended inservice
courses with standardized curricula, the Life Saving
Skills (LSS) trainings and/or greater than 1 month
midwifery update courses at TSMC, RTCs or NMCHC. The
greatest increases in competency in infection prevention,
active management of third stage and bimanual
compression appeared to occur in midwives attending
LSS, while the greatest improvement in competency in
newborn resuscitation appeared to occur in midwives
attending other > 1 month midwifery update courses at
NMCHC or regional training schools. Current competency
levels of those assessed, however, are below 70 percent in
all clinical skills.
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Results: Competency (8)
• PMWs appear to be as competent as SMW in terms of
traditional competencies, but less so in terms of the “new
competencies”. Given that it is the “new competencies” have
a direct impact on reductions of maternal and newborn
death and morbidity, and that many HCs are operating with
one a PMW, this finding is of concern.
• Every effort should be made to increase the levels of
competence and confidence of all midwives, but particularly
the PMWs working in HCs, where births are taking place.
Greater attention needs to be given to supportive
supervision by technically skilled supervisors. A system
should be established whereby all midwives, in particular
those working where there is no medical doctor, should
have their competence assessed locally and action taken to
address areas of weakness. This should be an urgent
priority.
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