Pregnancy and childbirth are life-changing experiences for a woman; yet they can also be life-threatening when women do not have access to quality healthcare services. In Zanzibar, there are 310 maternal deaths per 100,000 live births and a majority of these deaths are due to severe bleeding, sepsis, eclampsia, obstructed labour, and the consequences of unsafe abortion. And for every woman who dies from the complications of pregnancy, an estimated 20 to 30 more experience chronic or acute morbidities. Most of these maternal deaths and morbidities are preventable with increased access to emergency obstetric care, skilled birth attendance, and family planning.
Making motherhood safer
Making motherhood safer is a human right, and is at the core of UNFPA’s mandate. Recognizing the need to improve Emergency Obstetric and Newborn Care (EmONC) in Zanzibar, UNFPA began working with the Ministry of Health in late 2016 on a mentorship programme to address knowledge and skills gaps among healthcare providers. Two senior obstetrician gynaecologists were posted to medical facilities in Unguja and Pemba (main islands of the Zanzibar Archipelago) to mentor medical doctors, medical officers, and midwives, with the goal of increasing their skills and capacities.
Dr. Ramadhan, a newly-qualified doctor, was posted to the maternity unit of Wete District Hospital, Pemba, in May 2017. On taking up his position, he felt he lacked the confidence to conduct certain procedures. Caesarean sections were of particular concern as he had only completed one C-section under supervision during his training. “I would love to conduct caesarean sections by myself but I’m afraid I’m not confident enough,” Dr. Ramadhan said.
Building skills through mentoring
Dr. Ramadhan received support during clinical practice and over the course of his mentorship, he developed his skills under the watchful eye of a very experienced medical professional. By March 2018 he had successfully performed 40 C-sections without the need for supervision, and his capacity to deliver EmONC has improved. With his enhanced skills and confidence, he saves lives.
This support has made a huge difference to Dr. Ramadhan’s work. When asked about the difference the mentorship programme has made, he said: “I feel empowered because I am saving the lives of mothers and newborns in Zanzibar. I feel that I’m making an impact, however small, in reducing maternal and newborn deaths, this gives me a sense of satisfaction.”
The UNFPA-supported mentorship programme is proving very successful as an effective approach to transfer knowledge and skills. Healthcare professionals can build their capacity without the need to leave their duty station for training and workshops – this is essential in an area like Zanzibar, where human resources for health are constrained. Mentees appreciate the more practical style of learning on a daily basis, as this reinforces the theoretical training they have already received as students. Moreover, this approach is far more cost-effective compared to workshop settings when the costs of removing staff from health facilities are incurred.
