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Partner Q&A: Dr Beatrice Mwilike, Tanzania Midwives Association

About

Dr Beatrice Mwilike (PhD) is the new President of Tanazania's national professional association of registered and enrolled midwives. Tanzanian Midwives Association (TAMA) has over 3500 members, and is active in 26 states across the country. Dr Beatrice's appointment as president comes at an important time for the mothers and newborns in Tanzania as the country looks to scale the impact of programs like Safer Births Bundle of Care (a program TAMA is a key partner in) to reduce preventable deaths. 

In this conversation, Dr Beatrice reflects on the strategic aims of TAMA moving forwards and the important role midwives can and will play in improving health outcomes for women and babies. 

As the incoming specialist for the Tanzania Midwives Association (TAMA) in the role of president, what initiatives do you plan to champion? 

Advocacy for midwives' rights, professional development, and recognition within Tanzania's healthcare system can be approached through several strategic actions. 

  • Professional development can be promoted by supporting continuous education and training initiatives with TAMA and other stakeholders of RMNACH+N. For instance, the twinning program between the Canadian Association of Midwives (CAM) and TAMA is an excellent example of how international collaboration can enhance midwives' skills and knowledge. We are currently implementing a project to strengthen midwifery in Tanzania, and continuous professional development is among the key activities.
  • Advocating for midwives' inclusion in policy-making processes can increase recognition of them as vital healthcare providers. This involves ensuring that midwives have a voice in health sector reforms and that their contributions are acknowledged nationally and internationally. Therefore I will ensure that the midwives voice is heard by starting engaging with policy makers and parliamentarians to understand who is a midwife and the vital role they play in RMNCAH+N services.
  • Performing public awareness campaigns to understand the midwifery profession, the critical work midwives do, and their impact on maternal and child health outcomes.
  • Advocating for the government to provide a conducive working environment that values the work of midwives. This can be done by ensuring the availability of adequate resources essential for midwives to carry out their responsibilities efficiently.

TAMA is a key national partner for Tanzania's Safer Births Bundle of Care program (SBBC). What are your reflections on the program, and what do you hope for it in the future? 

The Safer Births Bundle of Care (SBBC) program's approach, which integrates innovative tools and training methodologies, has been instrumental in reducing maternal and newborn mortality rates. The SBBC program's emphasis on simulation training, data-driven quality improvement, and efficient management of postpartum haemorrhage (PPH) has led to promising results, including a substantial decrease in maternal deaths. I hope that the success of the SBBC program will serve as a testament to collaboration, evidence-based interventions and local innovations in addressing critical maternal and perinatal health challenges. As TAMA continues to be a key partner, its contributions will be vital in achieving the program's future objectives and ensuring that all births in Tanzania are safe and supported by the highest standards of care. 

One of the pressing issues in Tanzania is the shortage of midwives in rural and underserved areas. What strategies do you believe can be effectively implemented to address this issue? 

Addressing the shortage of midwives in rural and underserved areas in Tanzania is a complex challenge that requires a strategic approach. These can be:

  • Developing pre-service training courses that ensure midwives are well-prepared for the challenges they will face in rural settings.
  • Recruitment of students from rural areas for midwifery training, as they are more likely to return and serve in their communities. 
  • Creating linkages between training institutes and practicum sites in rural settings to increase exposure and ensure that students receive hands-on, skills-based training, which is crucial for their professional development.
  • Provide financial and non-financial incentives to attract and retain health workers in rural areas. Non-financial incentives, such as opportunities for career development, recognition, and a supportive work environment, are important in retaining skilled midwives.
  • Lobbying for support from non-governmental organizations and churches/mosques to improve the quality of life for midwives in rural areas by providing, for example, houses, entrepreneurship opportunities, etc.

How do you envision the role of midwives evolving in Tanzania over the next decade? 

With the country's population growth rate remaining high and a significant percentage of the population residing in rural areas, midwives are expected to bridge the gap between traditional birthing practices and modern healthcare systems. Integrating digital health technologies will likely transform the maternal and newborn care arena, enabling midwives to improve the quality and reach of their services. Also, as non-communicable diseases become more prevalent, midwives will need to expand their expertise beyond traditional maternal care to address these emerging health challenges.

The evolving demographic profile, mainly comprising the young population, indicates that midwives must be prepared to meet the needs of a more informed generation with higher expectations regarding healthcare services. Midwives might also need to focus on enhancing the quality of care through continuous professional development and adherence to international standards, which can significantly reduce maternal and neonatal mortality rates.

Given your expertise, how can midwifery contribute to achieving Sustainable Development Goal SDG 3 (good health and well-being) in Tanzania? 

The role of midwifery is indispensable in advancing Sustainable Development Goal 3 in Tanzania. Midwives play a vital part in providing much-needed care to women during pregnancy, childbirth, and the postnatal period, even in under-served rural areas. Implementing innovative approaches such as community-based models and midwife-led mobile clinic services has been shown to significantly improve maternal health outcomes and advance health equity.

Midwives can use mobile health technologies to track and support women's health, allowing for timely interventions and better management of complications. In addition, midwife-led birthing units or home births with midwife support can be a safer option for low-risk pregnancies compared to traditional hospital wards.

In the broader context of global health, what is your perspective on collaborative efforts to strengthen midwifery education and practice? 

It is essential that midwifery education and practice collaborate in order to improve maternal and infant health worldwide. Comprehensive care is ensured by incorporating midwives into the healthcare system via education and practice. Positive outcomes are possible when midwives and other healthcare professionals collaborate, despite the obstacles that may arise. Alliances among governmental bodies, organisations, and institutions can promote mutual respect and facilitate the standardisation of practices and education through the pooling of resources. The primary objectives of these partnerships are to mitigate inequalities in the health of mothers and infants through a commitment to community involvement and equity.