Institute of health sciences



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Program Philosophy

The curriculum outlined in this document presupposes that both practice and education will be firmly community based. This is of the utmost importance. In the community the student midwife will be in contact with the people for whom she will provide services and also those with whom she needs to collaborate in her practice, for example, local leaders, women’s groups, schools, and so forth. This will enable the future midwife to grasp the realities of her client’s lives as they impact on the provision of reproductive health care.


Fundamental to the professional practice of midwives is the professional ethos that underpins all that a midwife does and how they function within society. Critical to this ethos is the relationship the midwife has to women, which by general consensus, is one of partnership, working within the framework of reproductive rights as outlined in ICPD Declaration of 1994. Therefore, midwives see their professional duty and thus their primary function as acting at all times to ensure the well being of the childbearing woman and her baby. To do this, midwives believe women should be empowered to assume responsibility for their health and that of their families. A core value being that midwives have confidence in and respect for women and their capabilities in childbirth8
The community midwife program embraces the following educational philosophy.9 The program:


  • acknowledges the uniqueness of the individual, whether student, client/patient or teacher;




  • promotes equal rights regardless of sex, race, religion, age, or nationality;




  • is committed to a life cycle perspective of reproductive health with a special focus on women's health;







  • increases the students’ awareness of family health issues and sexuality within a framework of gender sensitivity.


Program Aim

The aim of the community midwife program is to enable students to:







  • be caring, sensitive midwives who work alongside women and their families to educate, advise, facilitate choice, and respond to individual needs;




  • develop the ability to work well within a multi-disciplinary team to promote safe motherhood and reproductive health;




  • make a positive contribution to the reduction of maternal and infant mortality and morbidity by recognizing life-threatening conditions early and taking timely and skilled action;




  • reflect on their practice to promote learning from experience that will enhance their future care of women and their families;




  • recognize that learning is a life-long process and take every opportunity to keep up-to-date with research-based practice, using different forms of continuing professional education; and




  • develop into midwives who value their profession and contribute to the development of the profession by advocating change, where necessary, and by improving the care given to women and their families.


Key Midwifery Concepts
Key midwifery concepts that define the unique role of midwives in promoting the health of women and childbearing families will be reflected in the educational approach and include: partnership with women to promote self-care and the health of mothers, infants and families; respect for human dignity and for women as persons with full human rights; advocacy for women so that their voices are heard; cultural sensitivity, including working with women and health care providers to overcome those cultural practices that harm women and babies; and a focus on health promotion and disease prevention.


Ongoing Needs

Much has been done to strengthen the pre-service education of midwives in Afghanistan however some gaps related to professionalizing midwifery remain.


One area is to continue to strengthen midwifery as outlined in the Islamabad Declaration10(2007) by further developing career frameworks, work environments and regulatory frameworks to ensure efficient, effective, and safe health systems. A process for regulating the practice of the different categories of health professionals, including midwives is not yet in place in Afghanistan. Regulation of health care seeks to ensure that health care fulfils technical, operational, and social requirements. The objectives of regulation are to guarantee efficiency, quality, and equity of health care and to protect individuals and society from undesirable outcomes or effects of the functioning of the health system and its elements. As midwifery and nursing education continues to improve and expand a regulatory framework is urgently needed. It is recommended to establish a national health professional council as well as a program for professional updating.
Additionally the community midwife, needs to work within an “enabling environment,” that is, to be supported by a fully functioning health system and linked to a referral system for the management of obstetric and neonatal complications. It therefore follows that developing a competency-based curriculum for midwives that embraces the wider concepts of reproductive health is only part of what is required to building an appropriate professional cadre of midwives in order to achieve reproductive health for all.

PROGRAM CONSIDERATIONS


Before implementing a community midwife education program, consideration must be given to the learning process, the learning environment, the preparation of teachers and classrooms, selection of clinical sites, the availability of learning resources, and the preparation of a simulated practice environment, as well as taking into account certain scheduling issues, as outlined below. In addition programs must comply with the national accreditation program for midwifery education which has established standards for the education of midwives. There are national standards in five areas: classroom and practical instruction, clinical instruction and practice, school infrastructure and materials, school management, and clinical areas where student midwives undertake clinical experience. These explicit and mutually agreed-upon standards enable schools to improve the quality of education.





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