Nurses and Midwives
Overview
Nurses and midwives are the backbone of healthcare services worldwide. In developing countries, and particularly in rural areas, they often have overall responsibility for diagnosis and treatment, for emergencies as well as chronic conditions, often without medical support.
During 2009, HIFA2015 is collaborating with WHO and leading nursing and midwifery organisations to focus on the information and learning needs of nurses and midwives, and we shall continue to address these issues right through to 2015. See: HIFA 2009 Challenge: Nurses and midwives
Our activities will include a literature review of information needs and how to meet them. This will build on what HIFA2015 members have already provided below.
What HIFA2015 members say
Quotes from the literature
Nurses
“A typical patient in Africa… knows that the nurse in the village’s one-room clinic has no computer to consult, no textbook, and maybe not even a telephone to call a neighbouring village for advice. There is simply no recourse to health information, no matter how complicated the case. The quality of care she receives, regardless of her condition, will be limited to whatever knowledge the nurse has retained from basic training.”
SatelLife 2005
“I have been working for more than twenty years as a public health nurse, routinely educating mothers on prevailing health problems. I’m still using the same knowledge to educate mothers on how to feed their babies. I feel like I’m not knowledgeable enough to give my clients updates, especially in this time of AIDS.”
Nurse quoted in Leshabari S et al 2007
“A survey of 21 hospitals in seven less-developed countries found inadequate knowledge and practice for managing pneumonia among 56% of doctors and nurses.“
Graham S et al 2008
“Severe malnutrition was both under-diagnosed and wrongly diagnosed by nurses trained in the use of the IMCI nutrition algorithm in a clinic setting in The Gambia.”
Hamer C et al 2004
“The books [Book Aid International] have helped our training programme significantly. As a result we were able to take care of the war wounded during the crisis in Freetown we were the primary facility for the treatment of the war wounded during the conflict. We performed over 900 different surgical procedures…”
Kojo Carew 2003
“When we don’t give them a straight answer, they doubt our knowledge, saying nurses do not know much nowadays. We look like fools.”
Nurse quoted in Leshabari S et al 2007
“We are overworked, and yet even when you are very tired you are expected to remember all the steps required as written in books. Are we computers that remember everything? We need to have something written down to refer to when counselling mothers.”
Nurse quoted in Leshabari S et al 2007
Midwives
““I am told that in many parts of the world it is traditional for an expectant mother to say goodbye to her husband and other children when she goes in to labour understanding that she may not see them again…. 80 per cent of these deaths – over 400,000 women [per year] – are still completely avoidable. ….The explanation for these deaths and health problems – is simple and terrible – when a mother faces a problem, there is no trained health worker on hand to help them.”
Sarah Brown 2008
“In Sierra Leone, one in eight mothers dies in childbirth. It is an astonishing and appalling statistic. There are only 18 midwives in a country of 6 million people. There are only 200 nurses, only a 100 doctors. If we can’t help in midwifery training and other things, then I believe that we will be failing a generation of people who deserve our people.”
Prime Minister Gordon Brown 2008
‘Every year, up to 70% of neonatal deaths occur – involving almost 3 million infants – because effective and simple interventions do not reach those in most need for care. The interventions that have the greatest effect are less dependent on technology and well-equipped facilities than on people with knowledge and skills… Knowing that 10,000 babies die every day, most of them from preventable causes, should give an impetus to the efforts on improving knowledge translation in poor countries.’
Wallin L 2008
“Lack of information and inadequate knowledge about signs of complications of pregnancy; danger signals during labour; and cultural practices are some of the reasons for high mortality rate in Nigeria.”
Esther Obiyan 2008
““In rural Sudan, we have seen a cyanotic, apnoeic newborn with a pulse be set aside following birth and left to herself to initiate the process of spontaneous breathing. After nearly two minutes of non-intervention by the delivery attendants, we were compelled to step outside of our role as observers and act quickly to provide stimulation and positive pressure ventilation. The infant responded to manual breaths and the outcome was good. Subsequent discussions with the local staff indicated that the infant would have been considered stillborn had she died… If just 1 in 100 stillbirths is actually a poorly-resuscitated viable newborn, greater than 30 000 lives could potentially be saved each year by improving neonatal resuscitation practices in austere settings.”
Spector J & Daga S 2008
References
Esther Obiyan, Programme Specialist, Maternal and Child Health, UNICEF.
Gordon Brown, Prime Minster, UK, 2008 Clinton Global Initiative Meeting.
Graham S et al. Bulletin of the World Health Organization 2008;86:349-355.
Leshabari S et al. Human Resources for Health 2007, 5:18 doi:10.1186/1478-4491-5-18.
Sarah Brown, Patron of White Ribbon Alliance and wife of Gordon Brown, Prime Minister, UK.
SatelLife. Handhelds for Health: SatelLife’s experiences in Africa and Asia. 2005.
Spector J & Daga S. Preventing those so-called stillbirths. WHO Bull 2008 (Apr);86:315-316.
Wallin L 2008. Evidence-based practice in a global context: The case of neonatal mortality. Worldviews on Evidence-Based Nursing 2008;167-9 (restricted access)
Acknowledgements
Our thanks to all members of the HIFA Challenge Working Group.
