Name: Ruth Maithya
Occupation: Nurse/midwife trainer at Amref Health Africa
Residence: Lives in Nairobi, Kenya.
Family status: Married and mother of three children between the age of 5 and 14.
Why did you become a midwife?
I got into midwifery, because I had a great mentor in high school. She was the school principal and she knew I loved science. I was actually planning to go into accounting, but my mentor encouraged me to pursue nursing and midwifery. This way I could combine my interest in science with helping people. I trained as a nurse midwife and I also have a post-graduate degrees in nursing education and gender studies.
I have never regretted becoming a midwife rather than an accountant!
What challenges do skilled birth attendants face in Kenya?
I worked for three years at the maternity unit at a county referral hospital in the Rift Valley region. Since this is a referral hospital, we would get more complicated cases. This has provided me with ample experience of emergency care, but ALL midwives must be competent to provide emergency care. Unfortunately, this is not the case.
If a woman lands in the hands of a skilled birth attendant who is not up to date with knowledge and skills, she could die. The so-called third delay – i.e. the delay in receiving adequate health care may be contributed by inadequately trained medical staff
Another problem is high staff turnover. A BEmONC trained midwife is often re-deployed to another health facility.
For this reason, BEmONC (Basic Emergency Maternal and Neonatal Care) is so important. It would be wonderful if every skilled birth attendant is trained on BEmONC – and is trained continuously. This is where The Safe Delivery App comes in handy!
What work do you do at Amref?
I started working with Amref in 2008. In my current job, I have trained nurses and midwives in Kenya, Uganda, Somaliland, South Sudan, Rwanda and Tanzania on Continuous Professional Development (CPD) courses to include BEmONC. A majority of our trainings take place at the Amref Virtual training school in Nairobi, where we run academic programs that can take up to 4 years. In our training programs we integrate e-learning and mobile learning.
How is The Safe Delivery App being used in Amref’s training program?
The Safe Delivery App is currently being used as part of Amref’s Maternal and Newborn Health project aimed at improving access to better maternal health services in Samburu county called Uzazi Salama – which is Kiswahili for “saving mothers.” Uzazi Salama includes an in-service 5-day training program targeted nurse midwives, midwives, clinical officers and medical officers, who all provide skilled birth attendance.
The Safe Delivery App has been used in the Uzazi Salama program to train 140 health care workers in Samburu. The trainers educate them on how to use the phone for learning in general and on skills-training through the App in particular. Our target is to train 314 skilled birth attendants with the App as part of their training program by October 2018.
How has The Safe Delivery App been received by Amref’s BEmONC trainers?
Recently, we surveyed 12 Amref master trainers on their perception of the App. The feedback was very positive and they really applauded the App! Some even said that it’s the best thing that happened to them.
They explained that the App makes a big difference in their work, because it shows step-by-step what to do in a standardized way. It makes the BEmONC training interactive. You can tell the students “Let’s go to this procedure” and they can then do a group activity based on the instructions.
It is also much more efficient, because the trainers do not need to take a lot of time to explain the procedure. It makes a big difference that the instructions are shown visually.
The government of Samburu has provided us with BEmONC training kits, which for example includes Laerdal’s neonatal doll. But the model is not worth much, if you do not have the skills to use it. So the App makes it possible for the trainer to utilize the training kit in the right way. This way, the App really complements the supplies we have in a good way.
What barriers do you see for scaling up the Safe Delivery App in your program?
One of the common challenges reported by our midwife trainers is the fact that not all phones have an android operating system. It can also be a problem to update the App if internet connectivity is not available. Also, the app is quite big and some devices slow down upon installation of the app!
Going forward, how will Amref use the App?
The App fits very well with Kenya’s national guidelines for maternal care, which is really important for national buy-in.
I believe that the Safe Delivery App could potentially be used in our pre-service trainings, i.e. for the primary education of nurse/midwives. These 19-25 year-old students, who are just out of high school, are from a generation that all use smart phones. The App would be easily recognizable for this young, digital generation. If this becomes the case, it would break the ground for implementing the App on national scale in Kenya.
What is your personal experience from using The Safe Delivery App?
I am personally motivated by using the App. As a trainer, I need to be well-informed all the time. Therefore, I often use the App to refresh my memory, for example before I do a lecture. I also encourage all midwifery trainers I know to download the App!
Photo: Ruth Maithya and her colleagues (midwifery and nurse trainers) with the Safe Delivery App at the Africa Health Agenda International Conference in Nairobi in March 2017.