Background:

The Government has endorsed the strategic directions for enhancing the contribution of nurse-midwives for midwifery services to contribute to the attainment of the Millennium Development Goals 4 and 5 The strategic directions include six-month post-basic midwifeiy education programme for existing nurse-midwives. This is in recognition of foe feet that midwives and midwifeiy service are integral to the achievement of MDG4and5.

Overview of the strategic directions:

1. Policy and Planning: Develop and implement strategies for effective utilization of nurse midwives as an integral part of the Human Resource Policy and workforce plan.

2. Training and Education: Strengthen midwifeiy knowledge and skills to perform quality Maternal and Neonatal services according to education, qualification and title.

3. Deployment and utilization: Deploy nurse midwives based on workforce plan and ensure supportive environments/health facilities to provide appropriate maternal and neonatal health services.

4. Regulation: Review and update the regulations under Bangladesh Nursing Council to enable the practice of nurse midwives for midwifeiy services.

Strategic actions related to training and education: • Develop skilled trainers and facilitators with modem teaching/learning methodologies to conduct trainings for Registered Nurse Midwives • Assure quality of education and

training of the Nurse Midwives

• Develop and implement and additional(6 months duration) need and competency-based training programme for Registered Nurse Midwives • As per policy decision, develop and implement pre-service educational programme for a new cadre of midwives to meet the needs of the country to reduce the high maternal mortality rate, newborn mortality rate and unders mortality rate Updates:

• Based on strategic direction a 6 month post basic midwifeiy curriculum with syllabus, implementation guide and assessment guide are developed by the curriculum working group formed by the Bangladesh Nursing Council

• Curriculum working group comprises the member from Bangladesh Nursing Council, Directorate of Nursing Services, Nursing Colleges, UNFPA, Obstetrical and Gynaecological Society of Bangladesh, Bangladesh Medical

Association, Neonatal Forum, Paediatric Association worked for the curriculum development with the temporary international professional midwifeiy advisor through WHO

• It aims to prepare midwives to practice indepen dently, and appropriately advocate, consult with and refer to obstetricians. These midwives will provide skilled midwifery care to women and newborns within their scope ofpractice.

• WHO and UNFPAiointly supporting Bangladesh Nursing Councilfor proper implementation of mis program

•A baseline study is the process to assess present scope of midwifery practice, existing knowledge, attitude and skills of the Nurse-Midwivesfiom selected hospitals where program will be introduced.

• Training Site assessment using tiie assessment tools is in progress supported by UNFPA