Transformative Leadership, the Empowerment of Midwives

“The goal is to ensure that every service manager can be an agent of transformative leadership in the area of their work,” Ruth Maithya, a Nurse/Midwife Trainer at Amref Health Africa, told the participants at a stakeholder roundtable celebrating the training of 50 midwifes in five countries in the new Certificate Course for Leadership, Management, and Governance.

Working in close partnership with Amref Health Africa, the Leadership, Management & Governance (LMG) project worked with midwives in Ethiopia, Kenya, Malawi, Tanzania, and Uganda on a practical, experiential-learning approach to prioritized skills including: team work and communication, advocacy, coaching and mentoring, database management and decision making, change management, and strategic problem solving process.

At the roundtable on July 10^th in Nairobi, five of the midwives trained and two of the trainers representing all five countries shared their stories on how the training has impacted them with stakeholders from the Kenya Ministry of Health, the Nursing Council of Kenya, Nurses Association of Kenya, and the Confederation of African Midwives Associations. Each of the midwives faced different challenges and used their training to address them.

Linvell Nkhoma, a midwife manager in Malawi, explained how she’s been using managerial skills to help ease overcrowding in the maternity ward at the regional hospital where she works. “We have limited space, only three delivery beds for 400 deliveries a month. This program has taught me to prioritize and mobilize resources.  We have now shifted mothers that will have C-sections to a different ward, so there are more beds available in the delivery ward.”

At her hospital in Tanzania, midwife Sophia Mchinjita used the new skills from the training to solve a human resources problem. The lack of adequate nursing staff prompted her to recommend  two shifts instead of three shifts to have more people on duty. “It only required staff to stay two additional hours and improved patient coverage,” she said.

The course has helped expand solutions and options for the midwife participants and  Agnes Masawe, a trainer in Tanzania, explained how . “Sometimes you don’t need money, you need your mouth.  You need to lobby, communicate, and demand resources. Sometimes you think you need to talk to people in the capital city, but you can mobilize in the community.  You can do things yourself, not wait on the decision-makers.”

Florence A’teng, a midwife manager in Tanzania, agreed, “There is a funding ceiling given by the Minister of Health that you have to plan within and it is very small. You have to work around the budget constraints.”

National stakeholders in attendance were impressed by the midwives’ stories. Luisa Muteti, Chairperson of the Confederation of African Midwives Associations, Kenya Chapter, said “This project is a spring board to help us integrate what we know about leadership, management, and governance to midwife training.”

Mercy Kasina, Department of Nursing of Kenya’s Ministry of Health, stressed that midwife leaders are vital to making positive health gains. “If we reach a high level of midwifes at a managerial and leadership level, it will be much easier to reach health campaign goals and commitments.”