More women die during childbirth in South Sudan than in any country on Earth — over 2,000 mothers per 100,000 live births. According to the World Health Organization (WHO) and United Nations Population Fund (UNFPA), properly trained and equitably deployed midwives could prevent over 90% of maternal deaths in low-resource settings.

Building Capacity to Help Midwives Save Lives

Over this last week, local facilitators from Juba and a team from Amref Health Africa and Management Sciences for Health launched a capacity development training with eight South Sudanese midwifery managers called the Leadership, Management & Governance (LMG) for Midwifery Managers Certificate Course. The course helps midwives learn and utilize practices that can help them become advocates for their profession, as well as for mothers and newborns in their communities. It also prepares participants to mentor junior midwives and lead teams to implement life-saving practices. Upon completion of the course, midwives are equipped to scan their environments, identify challenges and solutions, plan for and implement programs, mobilize stakeholders, and monitor and evaluate essential midwifery activities. After five days of learning, the program provides the midwives with continual coaching from local supervisors and peer-to-peer learning for six months — supporting them to identify challenges in their health centers that they want to work on, to develop projects, and to achieve health service delivery results.

Challenges to Delivering Life-Saving Midwifery Care in South Sudan

Negative societal perceptions of midwifery as a profession and the scarcity of midwifery training programs have led to a direly low number of certified midwives in South Sudan. According to the UNFPA, as of 2012, the entire country had just eight registered midwives. Judith Cenia, a midwife and local LMG Certificate Course for Midwives facilitator from Juba, shared, “Our girls are taught that midwifery is not a respectable career — that only girls who drop out of school or can do nothing else become midwives.” To address this and other similar perception challenges, the LMG for Midwifery Managers course aims to build the capacity of midwife managers with the competencies that are necessary for them to lead and manage in their clinics and health system.

Recovering from decades of civil war and still facing violence from militia groups, women have been scared to travel to health centers for antenatal care or delivery after years of assaults on the road to her health center. According to midwife Rachael Clement, an LMG course participant, “Pregnant women have to be educated that it is safe to come again and that it is important to come [to the health center]. They don’t know it is safer now.”  With support from her coach, Rachael is leading an outreach campaign with her colleagues to educate community members on new security measures to help the community to feel more comfortable to safely access life-saving maternal care.

Custom Leadership Solutions to Complex Problems

Ultimately, one out of seven mothers dies in childbirth in South Sudan. With the aim of preventing maternal death, LMG for Midwifery Managers Certificate Course in South Sudan equips midwives with the skills it takes to identify problems in their workplaces and to lead and manage teams to solve them. This first group of midwives are addressing workplace challenges related to: improving access to and quality of maternal care; developing staff trainings in infection control procedures; community education campaigns for antenatal care and the importance of skilled birth attendants; advocating to community leaders for resource mobilization for their health centers; and involving men in peer-to-peer education on the importance of male involvement in maternal care. Local supervisors will continuously coach these participants through implementation of their selected service improvement projects, allowing them to practice their newly learned leadership and management skills. Results from their projects will be gathered throughout implementation, culminating in their final certification and course completion after six months — in October 2015.