A set of five spiral-bound training manuals developed to help equip midwives with essential life-saving skills.The manuals, which were widely field tested in Africa, Asia, and the Pacific prior to finalization, respond to the need for midwives to understand the conditions that lead to maternal death and know how to treat or prevent them. Logically organized and abundantly illustrated, the manuals aim to communicate in an imaginative way the sound knowledge that midwives need in order to think critically, make the right decisions, and apply the appropriate clinical skills, particularly in life-and-death emergencies.
The modules, which were prepared for the in-service training of midwives and nurse-midwives, rely on a range of problem-based learning methods designed to maximize student involvement. Emphasis is placed on the application of theory to practice, making visits to the community an integral part of the learning process. Each module includes a suggested timetable for the sessions together with recommended methods of teaching and learning. These range from traditional classroom lecture and practical exercises to role play, drama, story telling, case studies, and learning games and puzzles. Most of the teaching aids described can be easily prepared using materials readily at hand in developing countries.
The modules are not intended to substitute for a textbook on midwifery; students are expected to have received training in such basic skills as measuring blood pressure, performing a vaginal examination, and conducting a normal delivery.
- Foundation Module: The Midwife in the Community
1996, 160 pages + 1 game [E]
Teaching sessions deal with the general issue of maternal mortality, the factors which contribute to avoidable death, and the importance of community participation in helping to make motherhood safer. The module opens with the story of Mrs X, which shows how certain social, economic and cultural factors, combined with delays in seeking medical care, put mothers at risk of complications which frequently lead to death. These topics are then further elaborated in the remainder of the module, with special emphasis being placed on the role that midwives can play in promoting safe motherhood in the community.
Specific topics covered include the place and value of women in society, traditional beliefs, practices and taboos affecting the health of women during pregnancy and childbirth, the recognition and reduction of risk factors, and the concept of delay as it relates to maternal death. Additional sessions cover the use of community profiling for planning community-based care and the evaluation of its effectiveness. Learning methods used include story telling, community visits to assess conditions and collect data, role play, practical exercises, and simple but instructive games.
- Postpartum Haemorrhage Module
1996, 214 pages +1 game [E]
Teaching sessions begin with a detailed explanation of the physiology and management of the third stage of labour. Students then learn what postpartum haemorrhage is and how it occurs. Skills covered include identification of risk factors, management of the third stage of labour, massaging the uterus and expelling clots, applying bimanual compression to the uterus, and applying manual compression to the aorta. Other sessions explain how to suture perineal tears, suture an episiotomy, repair cervical and high vaginal tears, and remove the placenta manually.
- Obstructed Labour Module
1996, 168 pages [E]
The opening session reviews fundamentals of anatomy and physiology relevant to the management of obstructed labour. Subsequent sessions explain risk factors and offer guidance on how to identify the signs of obstructed labour. Special emphasis is placed on use of the partograph in monitoring labour. Skills covered include identification of risk factors, assessing pelvic capacity, diagnosing presentation and position of the baby, assessing descent of the fetal head, and recognizing obstructed labour.
- Puerperal Sepsis Module
1996, 154 pages [E]
An explanation of puerperal sepsis is followed by sessions dealing with underlying risk factors, identification and differentiation from other conditions, prevention, and management. A session on HIV and AIDS, related to childbearing women, is also included. Skills covered include identification of risk factors, signs and symptoms, taking a midstream specimen of urine, taking a high vaginal swab, and maintaining vulval hygiene.
- Eclampsia Module
1996, 128 pages [E]
An introduction to pre-eclampsia and eclampsia includes basic information about hypertension, proteinuria, and oedema, and explains the stages of an eclamptic fit. Subsequent sessions deal with risk factors and their identification, prevention, and management. Teaching aids included in the manual illustrate the clinical features of eclampsia, epilepsy, cerebral malaria, meningitis, subarachnoid haemorrhage, cerebral tumour, uraemia, and septicaemia. Skills covered include identification of risk factors, differential diagnosis, midwifery and nursing observations, taking of blood samples, intravenous infusions, insertion of a catheter, and care and observation during an eclamptic fit.