The Association of Malawian Midwives
AMAMI was established in 1997 after one of Malawi’s prominent midwives had attended an International Confederation of Midwives (ICM) conference in Oslo in 1996. In 1998, AMAMI became a member of the International Confederation of Midwives (ICM). The association was governed and operated by a volunteer board for most of its history. In 2011, the Board of Directors hired an office manager, and in 2013 created and filled the position of executive director and technical advisor.
Sponsored 31 midwives for first ICM conference in Africa
AMAMI gathered funding from a variety of donors in order to send 31 Malawian midwives to Durban, South Africa for the continent’s first ICM conference. Donors included the Ministry of Health, UNFPA, USAID, the Royal Norwegian Embassy, Kamuzu College of Nursing, and Nurses and Midwives Council of Malawi.
Publicized ICM’s World Midwifery Report
With the participation of the Minister of Health, AMAMI publicized ICM’s World Midwifery Report at a conference in Lilongwe. The report highlighted the need for each country’s commitment to strengthen midwifery services in order to ensure that every woman and her new born baby have access to quality midwifery services. The conference was funded primarily by UNFPA.
Completed the association’s strategic plan, sought funds for its implementation
AMAMI finalized a strategic plan which is now operational. Several proposals were written during the year requesting funds to implement portions of the plan.
Conducted MACAT survey
In order to more accurately identify its strengths, weaknesses, opportunities, and threats, AMAMI surveyed a variety of stakeholders using the Member Association Capacity Assessment Tool (MACAT). The findings proved useful as the Executive Committee worked on the association’s strategic plan.
Organized two regional conferences
AMAMI conducted conferences in the Northern and Central Regions of Malawi during the year. At the Northern Region conference, AMAMI disseminated its strategic plan,survey findings from the Member Association Capacity Assessment Tool (MACAT), Continuing Professional Development updates, and State of World Midwifery Report. The conference helped build awareness among participants about the purpose of AMAMI and its membership benefits.
The Southern Region conference brought together lecturers and tutors from nursing and midwifery colleges in the region. The main objectives were to share current regional, national and international information on reproductive health issues, equip participants with current information on abortion issues in Malawi, abortion’s impact on maternal mortality and morbidity, and abortion treatment and complications.
AMAMI held an orientation meeting for midwifery tutors, which attracted 40 participants.
Strengthened Secretariat and moved to new location
AMAMI’s Executive Committee agreed to increase the number of staff working at the Secretariat. Also, the AMAMI office moved from Chitenje Maternity Trust at Kamuzu Central Hospital to Area 14 at the Maikhanda premises.
Sought recommendations for an AMAMI position statement on abortion care
In an effort to reduce maternal and child mortality due to unsafe abortion, AMAMI organized a workshop for midwives to develop a position statement on abortion consistent with ICM guidelines. Twenty representatives from the Ministry of Health’s Reproductive Health Unit, Nurses and Midwives Council of Malawi (NMCM), National Organisation of Nurses and Midwives (NONM), nursing schools, and district hospitals participated in the Ipas-funded workshop. It was intended that recommendations from this workshop would be brought to a larger group of stakeholders for further consideration.
Recognizing the controversial nature of this issue—morally, politically, and socioeconomically—and the negative impact of unsafe abortions, it was felt that it was important for AMAMI, as a key stakeholder, to have a position statement regarding abortion-related services. As articulated by a variety of international bodies, the statement should include affirming the following steps: 1) increasing couples’ access to modern contraception to prevent unintended pregnancies, 2) improve the quality and accessibility of post-abortion care, 3) expand access to safe, legal, voluntary and affordable abortion care, and 4) where possible, change laws that have punitive measures against illegal abortion.
Developed initial draft of AMAMI abortion care position statement
Based on the recommendations of the previous workshop, this Ipas-funded meeting worked to develop an initial draft of a position statement regarding abortion-related services. It was suggested that AMAMI needed to elect a task force to draft the position statement, circulate the draft position statement to members, and then convene a meeting for midwives to discuss and agree on the statement. The task force of Malawians midwives developed such a statement, which will be finalized when funds are available.
Sponsored 14 midwives, nurse midwifery students at evidence-based practice conference
AMAMI, in association with its developing partner UNFPA (United Nations Population Fund), brought 14 AMAMI members to participate in the 12th annual Sigma Theta Tau International’s conference in Blantyre. This international nursing and midwifery honour society provides a forum for professionals to share experiences and improve their knowledge and skills in rendering quality nursing care. AMAMI members contributed several presentations on research studies conducted in Malawi.
Participated in ICM/UNFPA Malawi gap analysis, midwifery strategy workshop
Twenty-five participants from midwifery education, regulatory and association bodies met to identify the needs and gaps in midwifery services in Malawi and to develop action plans and a strategic plan that Malawi could use for advocacy in midwifery and improving its services.
The discussions made clear that Malawi has the structures and systems in place for the education and deployment of midwives. However, these structures and systems faced a number of critical challenges that needed to be addressed by:
· More clearly defining standards for various levels of midwifery training and education.
· Revising the existing scope of practice of midwives to provide the required public protection and clear role of the midwife in the health care system.
· Adopting a culturally relevant legislative instrument that mandates the Nursing and Midwifery Council of Malawi in its current form. The existing version was developed in the 1960-70s.
· Developing a midwifery educational policy that guides pre-service education in the health sector.
· Re-positioning and strengthening AMAMI to be a strong advocate for the mother and her newborn through a well-organized management system with strong financial standing through diverse fund raising strategies.
As a result of these discussions, the workshop participants, within the framework of ICM’s global standards on midwifery education, regulation and association:
· Identified gaps that exist in Malawi’s structures and systems.
· Developed action plans to strengthen midwifery in Malawi.
· Made recommendations for implementing the ICM standards in Malawi.
Planned and conducted AMAMI’s annual conference
AMAMI brought midwives from across the country to participate in the association’s annual conference. The conference was organized in order for midwives to commemorate the International Day of Midwives and to conduct AMAMI’s executive general elections. Participants also shared knowledge, skills and challenges they face in their respective working areas as well as ideas on how to improve quality of midwifery care in health care settings in Malawi.
In addition, the Deputy Minister of Health presented awards to midwives who were nominated at the district level for exceptional performance. AMAMI will continue these awards in the future as a way to motivate midwives and midwifery students to dedicate themselves in their jobs.
In the business section of the conference, AMAMI’s treasurer presented the association’s audited financial report. It also was announced that AMAMI membership fees would be increased by K500 to K2,000 for RMS; by K300 to K1,000 for EMS/NMTS; by K100 to K500 for Student. These increases will help AMAMI increase its financial base and strengthen its long-term sustainability in order to reduce donor dependency. Finally, elections were held for AMAMI Executive Committee positions for 2012-15.
Organized International Day of the Midwives celebrations throughout Malawi
Attracting attention from newspapers, radio stations and television, AMAMI organised activities to highlight the crucial role midwives play in the health of mothers and children. Malawian midwives gathered at Queen Elizabeth Central Hospital, Zomba Central Hospital, Mzuzu Central Hospital, and Bwaila Hospital. Activities included services to patients—assisting in the labour, antenatal and postnatal wards, and cleaning—speeches, refreshments, and discussions among the participants.
Took the lead in developing a midwifery strategy for Malawi
In collaboration with the Nurses and Midwives Council of Malawi (NMCM), AMAMI conducted workshops to develop a national midwifery strategy based on a gap analysis performed jointly by the International Confederation of Midwives (ICM) and the United Nations IFPA. The analysis focused on the gaps that exist in Malawian midwifery services related to education, regulation, and association. The workshops, including a one-week stakeholders meeting, resulted in a draft strategic plan and action plans that will be finalised in the coming months.
Recruited AMAMI Executive Director/Technical Advisor
Following consultations with UNFPA and the Ministry of Health, AMAMI received funding to recruit for the newly created position of Executive Director/Technical Advisor to facilitate the implementation of the AMAMI strategic plan. Mr. Flemmings F.B. Nkhandwe was hired and joined AMAMI on 1 July, 2013.
Sponsored eight AMAMI midwives at ICM regional conference, CONAMA inaugural
AMAMI sponsored eight Malawian midwives to attend the Third International Confederation of Midwives (ICM) African Conference and the inaugural launch of the Confederation of African Midwives Associations (CONAMA) in Kenya. The conference was part of triennial initiatives by African midwives to influence continental policy making and collective competency building and to enhance their roles in improving maternal and newborn health. The events brought together an estimated 700 midwives, maternal and child health specialists, research scientists, programme planners, medical practitioners, policy makers and other stakeholders.
Launched USAID-funded project to improve pre-term care and strengthen AMAMI
Funded by USAID and partnering with a variety of other organizations, AMAMI launched a multi-faceted project to reduce premature births and reduce mortality of neonates born prematurely. The project also is designed to strengthen the organizational and leadership capacity of AMAMI.
The project, which is on-going in 2013, will focus on: 1) training 120 AMAMI member midwives in pre-term care best practices, 2) building AMAMI leadership skills to conduct supervisor visits and perform 40 health facility monitoring visits, and 3) increasing the skills of the AMAMI executive team to effectively govern and manage the association.
AMAMI is partnering with several organizations on this project, including Strengthening Health Outcomes through the Private Sector (SHOPS), U.S.-based clinical professional associations, Support for Service Delivery-Integration (SSDI), Save the Children, and Jhpiego. Other potential partners include East, Central and Southern Africa (ECSA) Health Communities and Regional Centre for Quality of Health Care (RCQHC) at Makerere University.