Shortage of bedside midwives a cause for worry


Eighteen year-old Patricia Kalumpha of Chiradzulu District has always harboured ambitions to serve humanity through nursing. Raised from a family that earns a living through small scale farming Patricia has staggered, though her secondary education through charity.

She says Chiradzulu District Welfare Office was instrumental in paying for her school fees at Providence Secondary School.

Still romancing her dream career, Patricia, applied for a nursing and midwifery course, and luckily she has been selected to purse the career path at St Lukes College of Nursing.


“The headache I have now is how I will foot tuition and other expenses at the institution,” she said.

Patricia is supposed to pay about K960,000 for tuition and lodging and an extra K78, 000 for other training costs and pocket money.

At present, Malawi has one of the most critical shortages of bedside. Midwives in the Sadc region, recent research has indicated.


Findings, from a 2016 survey by Civil Society Organization, White Ribbon Alliance shows Malawi has a population of about 3, 420 midwives against a population of 4.1 million women of child bearing age.

Midwives spend at least 75 percent of their work-time on maternal and neonatal health service provision.

Statistics indicate one mid wife technician is currently assisting an average of 1,800 women.

The country’s training institutions are also facing capacity and material challenges to train enough nurses and midwives as principle for Mulanje Mission College of Nursing and Midwifery, Keith Mumuderanji Lipato, explains.

“For us to have enough midwives and nurses there are quite a number of players. As institutions our mandate is to train quality nurses and midwives. After training our collogues in the Ministry of Health there is responsibility to employ the students. Lately there has been high failure rate in the licensure exams administered by the Nurses and Midwives Council of Malawi. There were a number of factors that led to that failure rate, as colleges we are doing our part,” he said.

Lipato said the college has intensified both theoretical and clinical learning to ensure and improvement in pass rate.

He also says it is costly to train a nurse or a midwives because annually a student cough about K1 million.

“It costs about a million to train a student in a year at Mulanje Mission College of Nursing and Midwifery and thus even at the lower side. So most of our students are facing challenges to settle the money. In the past government would offer scholarship to all students who would qualify for nursing studies. But currently the scholarships are very limited,” he said.

Lipato also said the process of recruiting trained midwives and nurses is another cause of worry. He said the process is slow.

Lipato also said in 2016 over 3000 people applied to study at the college and about 2500 were qualified but due to bed and classroom space only 130 students were selected for studies.

Similar challenges are also being felt at University of Malawi’s (Unima) Kamuzu College of Nursing according to dean of midwifery studies, Dr, Ursula Kafulafula.

The White Ribbon Alliance for Safe Motherhood in Malawi has for the past 15 years been advocating for the rights of Midwives as a means to reducing Malawi’s high maternal mortality rates.

Due to inadequate midwives in public hospitals, some patients have also complained that they are attended to late when they seek medical attention.

The development has been singled out to be discouraging women from delivering at hospitals for fear of being humiliated by medical personnel.

A case in point is that of Limbe Health Centre in Blantyre which serves patients from Kanjedza, Soche, Manje, Machinjiri, Kachere and several other areas in Blantyre.

On a given day, the facility receives about 35 antenatal patients who pile up in a ward with a capacity of 18 beds.

And just outside the ward, a long line of expectant mothers await antenatal checkup, treatment and counselling.

As Hanifa Sanudi explains, some patients and women would wait from morning to late in the afternoon before being attended to.

Hanifa, who has just delivered a baby girl, says the facility has very few midwives a situation that makes it impossible for mothers to be given full attention before, during and after pregnancy.

“I was warmly welcomed when I came two days ago and I have delivered with no problems. But the challenge I have noted thus far is that there are only few midwives here and I am sure this is the case with other hospitals too. Because of that the midwife on duty has a lot to attend to. And I do not blame her for being elusive or being angry at anything,” she said.

However, White Ribbon Alliance Malawi Executive Director, Nancy Kamwendo, has called on Malawians to appreciate the challenges mid wife technicians are facing in public hospitals.

She also calls on the government to recruit as many health workers as possible.

“There are gaps as the survey we conducted found out. Most of the bedside midwives we have in the country work long hours because they are few and they work with few resources. So sometimes we just rush scalding midwives for misconduct but we also have to look at the welfare of the staff,” she said

Recently, Minister of Health, Atupele Muluzi, admitted to failure by the government to meet the demand for hospital services due to limited staff.

Early, this year the government said about 800 nurses and midwives will gradually be hired under the 2018/2020 global fund grant.

Malawi’s maternal mortality ratio is still very high, with 460 women per 100,000 dying in childbirth.

Midwives are vital to reducing maternal and newborn deaths but are severely undervalued and underutilized in Malawi. According to the UNFPA “State of the World’s Midwifery 2014” report, midwives can provide up to 87% of the care needed by women and newborns.

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