MOMENTUM: Developing a Model of Mentorship for Ugandan Midwifery

Addressing the poor quality of mentorship for student midwives in Uganda

The RCM received funding from the Tropical Health and Education Trust (THET) to implement a project continuing our work in Uganda, following the completion of the Global Midwifery Twinning Project (GMTP) in Cambodia, Nepal and Uganda in March 2015.

MOMENTUM began on September 1, 2015 and ran for 20 months. It was jointly implemented by the RCM and its partner the Uganda Private Midwives Association (UPMA). The RCM’s Global Team were managing the project and, along with the RCM’s Education Team, providing expert technical advice to the project.

MOMENTUM also involved close work with the Ministry of Health, the Ministry of Education and Sports and the Uganda Nurses and Midwives Council, who hold responsibility for national midwifery standards in Uganda. It also partnered with education institutions including universities and midwifery training schools.

MOMENTUM was part of the Health Partnerships Scheme, which is funded by the UK Department for International Development (DFID). MOMENTUM's key aim was to address the poor quality of mentorship for student midwives in Uganda.

The project aimed to develop:

• four clinical pilot sites as centres of student mentorship excellence
• a national standard for midwifery mentorship
• a module to deliver work-based learning to midwives to prepare them to become mentors

The project used an Action Research approach, which emphasised participation for all parties and included cycles of action and reflection to develop the most effective solutions. Action Research's expertise both within the UK and Uganda helped to guide the project participants through the research element of the project, which aimed to generate Ugandan solutions to midwifery mentorship challenges.

Uganda suffers from high maternal and newborn mortality and morbidity.

• In 2015, Uganda’s maternal mortality rate per 100,000 births was 343 (UK: 9).
• The infant mortality rate per 1000 live births was 44 in Uganda (UK: 4).
  (Source World Bank / WHO)

Midwives trained to the International Confederation of Midwives' competencies are able to prevent around 2 in 3 of these deaths in mothers and newborns. However, student midwives in Uganda receive poor quality mentorship during their practice learning, and so are often not fully competent when they qualify. The project aimed to improve the training of student midwives, to contribute to our vision of all mothers and babies in Uganda having access to quality midwifery care. The period of mentorship in student midwives' practice placements has been identified as a crucial intervention point by the RCM and its in-country partners, as good quality mentorship ensures:

• development of practical midwifery competencies
• demonstration of the achievement of the required standards for midwifery practice
• development of independent decision making capabilities and midwifery behaviours

A successful pilot project to improve mentorship for student midwives at the Kibuli School of Nursing and Midwifery was undertaken during GMTP and this informed the design of this larger project. Following the success of this pilot project, MOMENTUM was devised to expand these placement opportunities to a wider group of midwifery students and to develop four clinical sites (representing the different Ugandan healthcare provider contexts) as centres for mentorship excellence.

MOMENTUM has been published in peer reviewed journals:

• From Midwifery - Developing a model of midwifery mentorship for Uganda: The MOMENTUM project 2015–2017
• From International Journal of Health Governance - Developing a national standard for midwifery mentorship in Uganda
• From International Practice Development Journal - Improving student midwives’ practice learning in Uganda through action research: the MOMENTUM project

MOMENTUM recruited seven RCM members as volunteers with relevant expertise for this project. The volunteers visited Uganda on two occasions for four weeks each. Between visits, the volunteers connected with their twins virtually to provide support, guidance and technical expertise. The Ugandan midwife twins travelled to the UK in 2016 to visit the RCM, undertake site visits to understand a different context of midwifery and mentorship and to deliver a paper at a conference.

For more information on MOMENTUM, visit Global Blogs or email global@rcm.org.uk.