Transcript Slide 1

International Confederation of Midwives
International Strategies for Strengthening
Midwifery
Frances Ganges, MPH, CNM
BOD- Americas Regional Rep
Strengthening Midwifery Globally
International Confederation of Midwives
The sole voice representing midwives globally
 Umbrella organization of professional midwifery associations
 108 member associations
 250,000 midwives
 98 countries
 4 regions
Africa
Americas
Asia
Europe
Strengthening Midwifery Globally
ICM Americas Region
 North America
 USA, Canada
 Caribbean
 Latin America
 BOD Regional Representatives:
 Mirian Solis – Latin America
 Frances Ganges – N. America/Caribbean
International Confederation of Midwives
Strengthening Midwifery Globally
International Confederation of Midwives
ICM History
1919: International Midwives Union
1934: International Federation of Midwives
1954: International Confederation of Midwives
Strengthening Midwifery Globally
International Confederation of Midwives
Midwives Associations
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Swedish Association of Midwives: 1711(!)
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Royal College of Midwives: 1881
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Ghana Registered Midwives Society: 1932
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American College of Nurse Midwives: 1955
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Trinidad and Tobago Association of Midwives: 1995
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Caribbean Midwifery Initiative: 2012
Strengthening Midwifery Globally
International Confederation of Midwives
Strengthening Midwifery Globally
International Confederation of Midwives
Strengthening Midwifery Globally
International Confederation of Midwives
Strengthening and promoting the profession
Focus of global efforts
 Global standards and tools (education, regulation, competencies)
produced to define scope of practice and guide governments
 Strengthening midwives associations - to promote autonomy and
ability to advocate and lobby governments. To aggregate midwives‘
efforts and influence policy
 Advocacy –raising the profile of midwives--Positioning and
professionalizing midwifery and midwives for visibility and impact
 Twinning – to disseminate expertise and knowledge among
midwives across national boundaries
Strengthening Midwifery Globally
International Confederation of Midwives
ICM global partners
 International Federation of Gynecologists and Obstetricians (FIGO)
 International Pediatric Association (IPA)
 International Council of Nurses (ICN)
 World Health Organization (WHO)
 United Nations Population Fund (UNFPA)
 White Ribbon Alliance for Safe Motherhood (WRA)
Strengthening Midwifery Globally
International Confederation of Midwives
Millennium development goals
Strengthening Midwifery Globally
International Confederation of Midwives
Midwifery: a critical workforce
for achieving MDGs 4,5 & 6
Making sure women throughout the world can give
birth… in the presence of a midwife, is the best
strategy for substantially reducing maternal mortality
worldwide....
Lancet Maternal Survival Series 2005
The world needs midwives now more than ever
Strengthening Midwifery Globally
International Confederation of Midwives
Challenges and Issues
 Acute shortage of midwives
 350,000 needed
 Number of trained midwives do not meet needs
 Diversity in midwifery definition and training
 Scope of practice inadequate
 Constraints on the role of the midwife in midwifery regulation
 Prescriptive authority lacking
 Lack of regulatory framework
Strengthening Midwifery Globally
ICM Council Decisions 2008
• Update existing & develop new core documents
• Work to be accomplished became known as the
“Three Pillars” of ICM’s global efforts to
strengthen midwifery worldwide
• Pillars include education based on updated
core competencies, regulation, and strong
Member Associations.
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International Confederation of Midwives
3 Pillars of ICM
Provides
practice
standards
Provides a
highly
qualified
workforce
Defines &
protects
scope of
practice
Provides professional support
Contributes to policy development
Supports relationships with other health care professions
Strengthening Midwifery Globally
Why ICM Standards?
ICM represents the world’s midwives.
ICM has goal to strengthen midwifery worldwide.
Need global consensus on how one educates a fully
qualified midwife*.
*Persons educated and trained to competency in all the ICM basic or
core competencies, legally recognized to practice full scope
midwifery, and who maintain competency over time.
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Need for Education Standards
 Many individuals use ‘title’ midwife
 Education varies as does quality
 Scope of practice & practice competencies vary
 Many countries needing midwives do not have a
midwifery education program
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Purpose of Education Standards
 Set quality indicators based on global
norms/expectations
◦ Standardize core elements of basic preparation
◦ Encourage flexibility in curricular design & content
 Provide framework for:
◦ Design
◦ Implementation, and
◦ Evaluation of ongoing quality of program
 Align scope of midwifery practice with regulatory body
◦ Establish ‘trust’ between employers & programs
◦ Provide credibility of graduates
 Hold midwifery program accountable to public
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The Process
 ICM Board appointed Education Task Force Co-Chairs
1/2009
◦ J. Thompson & A. Sawyer
 11 additional members confirmed 4/2009
◦ All ICM regions, 3 official language groups, WHO rep.
◦ Member of ICM Board & Education Standing Committee
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Reviewed existing literature & standards available
Drafted Preface, Standards, & Glossary 5/2009
IRB approval for international modified Delphi study 8/2009
Agreed need for Companion Guidelines
◦ How to implement the standard
◦ How to determine if standard is met
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Task Force Members
 Atf Gherissi – Tunisia
 Ellen Chirwa – Malawi
 Ans Luyben – Switzerland
 Kyllike Christensson –
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(ICM ESC)
Karyn Kaufman – Canada
Sally Tracy – Australia
Mary Higgins – Ireland
(ICM BOD)
Angela Sawyer – Liberia
Bente Silversten –
Denmark (WHO rep)
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Sweden
Hilda Bonilla – Chile
Rafat Jan – Pakistan
Nester Moyo – Zimbabwe
(ICM staff liaison)
Joyce Thompson – USA
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Key Documents Reviewed
• Core ICM documents & position statements
• WHO Midwifery Modules & Midwifery Toolkit (draft)
• WHO Global standards for the initial education of professional
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nurses and midwives (2009)
Accreditation Commission for Midwifery Education (2008)
– USA
East, Central, & Southern Africa Council on Nursing
(ECSACON): Professional nursing and midwifery
standards
European Union and United Kingdom midwifery standards
TF members country/regional standards for midwifery
education
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Research Question
What are the elements of quality that should be
reflected in any type of midwifery education
programme that prepares a person to meet the
ICM International definition of the midwife & ICM
Essential competencies for basic midwifery
practice ?
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Study Methodology
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Modified Delphi survey process
Internal (1) round
External (2) global rounds
Consensus at .80 (80%) level or above
Two-phase process over two years (May 2009
through December 2010)
Phase 1: development of survey instruments,
human subjects research approval – May to
September/2009
Phase 2: validation of standards, revising as
needed after each round with diverse panel of
stakeholders
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Country Responses by ICM Region
Africa
10/20 countries = 50%
Americas
9/14 countries = 64%
(plus 3 non-ICM member countries)
Asia Pacific 8/18 countries = 44%
Europe
19/36 countries = 53%
Overall response rate to electronic survey = 52% (46/88)
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ICM Global Standards
For Midwifery Education (2010)
Final Document
 Preface, Glossary, Standards and Guidelines
– post-secondary level of education to begin program
– 3 years minimum direct entry
– 18 months minimum post-health professional
 Framework for Standards:
I. Organisation and administration (6)
II. Midwifery faculty (8 plus 8 subparts)
III. Student body (6 plus 8 subparts)
IV. Curriculum (6 plus 4 subparts)
V. Resources, facilities and services (5 plus 5 subparts)
VI. Assessment strategies (5 plus 5 subparts)
Approval Process Standards
• Final drafts sent to ICM Board in November 2010
• ICM Board approved the Standards December 16, 2010, including
glossary of terms used
• ICM Board approved the revised Preface in January 2011
• ICM Board endorsed the developing Companion Guidelines 2010
• Spanish & French translations completed March 2011
• Documents placed on ICM website April 2011
• ICM Council overwhelmingly endorsed standards in June 2011
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Caveats
 These are minimum standards = adaptability
 Any country/program can exceed standards based on
country philosophy & needs
 Any country/program can exceed basic ICM essential
competencies based on priorities, needs
 Any country/program must exceed minimum length if
have other non-midwifery content included
 Any country/program can add more midwifery content –
extend length
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ICM Global Standards for Midwifery
Education (2010) with Guidelines
The steps ahead….
 Raise awareness about these Education
Standards and Companion Guidelines
 Discuss and develop processes for the Implementation
of the Education Standards in selected countries
 Support Implementation of the Standards by working
with partners and provision of adequate quality
education material and expert support
International Confederation of Midwives
The Midwife effect
I found – and it was not a finding I had expected – that wherever
(there was) a system of maternal care . . . based on trained . . . and
respected midwives . . . maternal mortality was at its lowest.
I cannot think of an exception to that rule
(Loudon 1992)
Strengthening Midwifery Globally
International Confederation of Midwives
Americas Regional Midwifery Conference
Quito, Ecuador
May 2013
Strengthening Midwifery Globally
International Confederation of Midwives
30th ICM Triennial Congress
June, 2014
http://www.midwives2014.org/
See you there…
Strengthening Midwifery Globally
International Confederation of Midwives
Thank You!
International Confederation of Midwives
Laan van Meerdervoort 70
2517 AN, The Hague
Netherlands
Telephone: +31 (0)70 306 0520
Fax: +31 (0)703 555 651
[email protected]
www.internationalmidwives.org
Strengthening Midwifery Globally