Supporting Midwives and Building Systems Capacity
We support the Ministry of Health to strengthen public sector services for maternal care, newborn care, and family planning. One of our first activities was the placement and training of Maternal and Child Health (MCH) District Program Officers as active members of the District Health Management Team in four initial districts (Aileu, Manatuto, Ermera and Liquica). Following this initiative, the Ministry of Health made the decision to take on support for this position in the rest of the districts in the country. This wise decision by the fledgling Ministry of Health signaled an important commitment to improve district-level management capacity for maternal and child health throughout the country.
During the initial period after independence, there was significant attention to improving the skills of midwives through a WHO-sponsored Safe Motherhood training; however, there was no provision for follow-up supervision visits to support midwives using their new skills. Likewise, following a more recent national family planning training for all midwives in the country, there was no provision to conduct a clinical skills check once the midwives returned to their home districts.
We saw an important programmatic opportunity in assisting the Ministry of Health by providing supportive supervision of midwives in six districts (the initial four plus Manufahi and Ainaro). Working with the Ministry, we developed an integrated supervision tool that is now used at the national level for monitoring and guiding the quality of maternal services delivered by district health staff. The midwives working in remote and rural areas in the six districts are grateful for the technical and management advice and problem-solving assistance provided by the our staff and the MCH District Program Officers.