Columbia Award strengthens midwives' safe motherhood work in Malawi: Martha Bokosi reports from Malawi on what has been achieved there following her receipt of the 2002 Columbia University Award.

This award is made annually by Columbia University, which hosts the Averting Maternal Mortality and Disability (AMMD) programme, to midwives in each ICM region. Part of its aim is to assist in strengthening the midwifery association in the country. The following report was sent in by Martha Bokosi:

As you are aware that I won the AMMD award amounting to $5,000, below are the details of the implementation report utilising the award funds.

The award money is intended to strengthen the activities and effectiveness of the Association for the Malawian Midwives (AMAMI).

The Association met on October 23, 2002, to map out some activities that will take place due to the availability of the above funds. Below is an account of the activities conducted so far as well as the remaining planned activities:

District Supportive Supervisory Visits

Four executive members of the Association of Malawian Midwives (AMAMI) toured major hospitals in the northern region of Malawi from January 6-9, 2003. The team comprised the President of the Association, the publicity secretary, the regional representative of the Association for that region and also one co-opted member.

The aim of the visits was to inform midwives in the region of die activities of the association and also to find out successes and challenges that midwives are encountering in their work. A total of seven district hospitals were visited, including two mission hospitals. The visiting team was able to meet a total of about 100 midwives.

The majority of the midwives were pleased with the initiative taken by the Association. They pledged to continue offering the best midwifery care to mothers, their babies and the community at large. However, they registered some concerns as follow:

* Critical shortages of staff in most maternity units which hinders them from offering the best care and expertise.

* Low pay and lack of other incentives for midwives despite their noble and challenging job

* Lack of staff appraisal

* Inadequate refresher courses for midwives in that region as compared to the Southern region where the Safe Motherhood Project operates.

The visiting team presented the above concerns to the Ministry of Health officials for their action. Prior to the visits the Association had also submitted a position paper concerning the critical staff shortages and specifically that of midwives which has resulted in closure of some of the maternity units.

Health Centre Visits: donations:

As a continuation of the 2002 theme 'Midwives working with women in their communities', members of the Association agreed to support two needy health centres during Christmas time. This was done in terms of provision of supplies that each individual centre needed. It was hoped that this donation would alleviate the problems of the facility, but at the same time raising the profile of the association. The donations were as follows:

Ndirande Health Centre: The facility received the following items:

* Chlorine for decontamination process

* Gauze and cotton wool swabs

* Forceps for conducting deliveries

* Gallipots and kidney dishes 

The District Health Officer's representative was present at the hand-over ceremony as well as staff of the health centre. The story, was also covered in the newspaper.

Ukwe Health Centre: The facility received the following items:

* Chlorine for decontamination

* Two sets of buckets/basins for decontamination in the maternity unit

* Mattresses and blankets for mothers in the maternity unit

* Mackintosh sheetings

Ministry of Health officials were present at the hand-over ceremony as well as health centre staff.

Implementation partners

The following people have participated in the activities:

* The executive of AMAMI

* The AMMD award winner

* Regional AMAMI representatives

* District-based midwives: including District Nursing Officers

* Patients who received the care utilising the supplied commodities.

The executive group intends to visit the central region of Malawi in due course.

Data from WHO on Malawi give: Total population: 11,571,000 Life expectancy at birth m/f (years): 35.7/36.9

Healthy life expectancy at birth m/f (years): 29.0/30.7

Child mortality m/f (per 1000): 261/240

Women receiving some antenatal care: 90%

Deliveries in health facilities: 55%

Skilled attendance at birth: 55%