Midwives Lead to End Preventable Child Deaths

  • Published Date: September 2017

Linvell Chirwa
Malawi

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Linvell Chirwa is a young midwife, but that does not mean she is inexperienced. In addition to her certification as a midwife, Linvell also holds a bachelor’s degree in nursing. Together, these specializations have helped her become the In Charge for the Family Planning and Antenatal Care Department at Mitundu Community Hospital in Malawi.

A regular work day for Linvell begins at 7:30am and runs to 4:30pm, but that is not always the case because she is one of the more senior midwives at the hospital, and she is on call all day and night to respond to any emergencies or complications, like premature births.

In recognition of her leadership potential, the Ministry of Health selected Linvell—and nine other midwives—to participate in the Leadership, Management, and Governance (LMG) for Midwifery Managers Course offered by the USAID-funded LMG Project.

During the weeklong course, Linvell began to reflect on some of the challenges she saw at Mitundu Community Hospital, and in particular her concerns over the hospital’s high mortality rates for premature newborns. She knew that the hospital had a kangaroo mother care program—an approach to care promoting infants being carried with skin-to-skin contact. “It was there,” Linvell said, “…but it wasn’t effective. It was not producing results.”

So Linvell put her LMG for Midwifery Managers Course skills straight to work: she informed doctors, nurses, and other midwives who helped deliver babies about the high mortality rates and how kangaroo mother care could prevent some of these deaths.

Linvell was no longer just a midwife or a leader; now she was an advocate. While working with her colleagues to reorganize the hospital’s program, Linvell began to think larger and longer term. She began to organize a small project to better equip the hospital’s “mother kangaroo room.”

While planning her project, she plotted some priority actions to help lower premature neonatal mortality like mobilizing more resources for the mother kangaroo room; educating midwives and nurses; and assigning a midwife to supervise the room.

“By using the skills I learned during the training, I was able to write the proposal and get funded,” said Linvell about a grant opportunity she found to support her project. When the team started Linvell’s project to improve kangaroo mother care services in December 2014, the hospital’s premature neonatal mortality rate was nearly 46 percent. However, six months later in May 2015, the rate was down to less than 20 percent.

“I learned self-awareness,” Linvell said, reflecting on her experience organizing staff to improve the hospital’s kangaroo mother room, “I have the potential to do something bigger than myself and bigger than this project.” And Linvell’s leadership has started to change mindsets around Mitundu Community Hospital.

“Right now, I am not in the maternity department, but there, everything is working. The kangaroo room is continuing. People are not perceiving it as ‘someone’s’ project, instead they perceive it by looking at the welfare of the baby and the mother.