Papua New Guinea: Bachelors Program in Midwifery – rural attachment
Ms Paula Puawe, Midwifery Coordinator, University of Goroka
The University of Goroka offers a Bachelor of Midwifery program for nurses who have completed a three-year nursing diploma at a school of nursing affiliated with a university. Graduates of the 18 months degree course are awarded a Bachelor of Midwifery. The curriculum links theory and practice to the competency standards of the Nursing Council of PNG. Students must spend 16 weeks in labour ward, four weeks in antenatal clinic, three weeks in special care nursery, five weeks in the obstetrics and gynaecology ward, and eight weeks in a rural health setting.
At the end of the midwifery course, graduates may work in urban hospitals, rural hospitals or health centres in urban, rural in remote settings. Most of the clinical practice is taught in urban hospitals and clinics. In order to prepare students to work in rural environments, eight weeks of clinical practice is conducted in a rural setting. While this allows them to experience resource-scarce environments, they have more contact with the community. A broader range of skills beyond clinical midwifery is needed in rural primary care setting.
The internship program helps trainee midwives develop community health skills to better respond to the needs of people. It was an opportunity to work in a community setting to understand traditional practices and beliefs about health and maternal and neonatal issues and how they manage at the community level. As most of the students return to work in rural and remote locations after graduation, rural placement is a crucial component of the program. It ensures that students are theoretically and practically prepared to work as midwives in any setting.
A total of 38 midwifery students were divided into five groups and each group was assigned an educator to a rural health centre in Eastern Highlands Province. The rural attachment was conducted for 8 weeks. Each group was to carry out a project in addition to the usual clinical practice in the rural health centre. The five project activities were postnatal home visits, clinical audit, community engagement, newborn care and rural staff capacity building and mentoring. Students gained additional skills especially in the areas of research, clinical audit, community engagement and postnatal home visit as this were all new innovative activities.
Rural health internship is part of the bachelor of midwifery program. The internship provides an opportunity for students to experience rural health practice and to be exposed to challenges and opportunities for improving maternal and newborn health. Both students and educators were positive of the program as it helped to build knowledge and skills in community health and provided rural experience in caring for women, newborns and families. The project recommended that the internship program becomes a mandatory part of the midwifery course.