Twinning midwives in Uganda

The Change Exchange consultants, Nimarta Dharni & Wendy Maltinski, with Royal College of Midwives, UK & Ugandan Private Midwives Association, Uganda

The challenge

The Momentum project is a joint venture between the Royal College of Midwives, UK, and the Ugandan Private Midwives Association (UPMA).  It was developed in response to two pressing needs; the high maternal/neonatal mortality rates in Uganda; and the outcome of the Global Midwifery Twinning Project (2015) that isolated the need to develop quality mentoring standards, skills and knowledge. 

To achieve this aim, the 20-month programme used an established community development twinning and mentoring approach, whereby Ugandan midwives who were acting as mentors to student midwives were twinned with UK midwives for knowledge and skill support.  The partners wanted to understand how the twinning worked and what were the outcomes for midwives involved.

Our work

Training input in Uganda was delivered at the start of the project, and two further workshops spaced roughly 6 months apart. The UPMA were keen to undertake a piece of research on the project to establish its value.  Before we left Uganda on this first visit, we attended a meeting with the Ugandan and UK project coordinators to consider the options for undertaking research on the project, the capacity to do so, the skills and knowledge inherent in the team for doing so, and research focus.  We had understood that despite substantial monitoring and evaluation forms, limited input of these had been completed.  On this basis coupled with our observations thus far, we recommended that a focus on a specific outcome such as self-efficacy of the mentors and students might be more manageable.  Through discussion, it was clear that our next best offer would be to support the up-skilling of research skills. On our return to Uganda, 6 months later, we delivered research skills workshops including conducting literature searches and focus groups and understanding the role of self-efficacy in behaviour. We continue to have input to the project and will support the research activity of the UPMA from afar.

The benefits

Benefits were realised beyond the project in the way that UK partners thought about their own work. The Royal College of Midwives Global Advisor said:

“…some things that are easy to remember so the capability motivation opportunity…I’ve learnt that.  It helped me to understand and also when we went to the last Learning and Sharing Event somebody was saying, “Oh, I don’t understand, we’ve done all this training, but it doesn’t seem to be making a lot of difference.”.  “Funny you should say that…What I’ve been learning from The Change Exchange is…” and then everyone was, like, “Oh, wow, that’s really profound.”

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