UWI adds midwifery studies to help public health gap

There is an average of 200 vacancies for qualified midwives in the public health system and UWI is now in a position to help rectify that gap.

UWI’s School of Nursing has a new full-time, two-year BSc Midwifery programme which is scheduled to begin in September 2022. It was developed to meet the needs of the Ministry of Health because of the lack of qualified midwives in the six public health institutions offering maternity services.

Dr Oscar Ocho, director of School of Nursing told Sunday Newsday, in the short term, the programme would only be offered to people licensed or registered with the nursing council of their country, and who has a minimum of three years nursing experience.

“In looking at the International Confederation of Midwives, their standard for what a midwife should be, as it relates to qualifications, is at the bachelors level. Therefore we have developed a curriculum that will allow for a registered nurse (RN), a registered mental nurse or a midwife who wishes to qualify at the degree level to be able to complete this programme in a period of two years.”

In year one, students would do both theory and clinical experience simultaneously, focussing on the normal processes of conception, growth and development of a foetus. In year two, complications and challenges to pregnancy would be introduced, as well as an understanding of their role and the importance of collaborating with the obstetrician.

Although not yet available, a four-year midwifery programme has been developed and approved.

Ocho said the Government Assistance for Tuition Expenses Programme does not cover the midwifery programme at the moment but UWI is in the process of applying for GATE. Still, so far, 29 applications were received, including one from Guyana and one from St Vincent and the Grenadines.

“The persons who have applied are committed to pay, which shows that people are very interested in their professional development so that they could be better and more competent practitioners.”

Previously, midwifery education was only available through the Ministry of Education, a certificate programme at Schools of Nursing and Midwifery at the Port of Spain and San Fernando General Hospitals, as well as an advanced diploma from the College of Science, Technology and Applied Arts of TT.

He said the programme caters for 25 students to ensure quality instruction and the opportunity for clinical practice. But, since it is the programme’s first year and the class is not significantly oversubscribed, all 29 may be accepted.

“Our aim is to develop competent clinicians who can be able to provide a high quality of care at all levels of the continuum for clients, including the family.”

The TT Registered Nurses Association told Sunday Newsday there are approximately 1,500 registered midwives (but not necessarily practising in TT), three of whom are male.

Asked why he believes there are so few men in the practice, Ocho said in his 41 years in the nursing profession, midwifery was seen as a specialised area and midwives guard their turf.

“I think, there being so few males in the field has a lot to do with how midwives saw males as nurses. In general, the midwives were not as willing to share their space with the males as much as the clients. When they (clients) are going through the process of delivery, all they want is competent professional support. They are used to male obstetrician/gynaecologists and a male nurse or midwife is expected to be just as professional in their delivery of care.

“But I believe now that midwifery has been identified as its own profession, we have midwives from TT being part of the Caribbean Regional Midwives Association and the international Confederation of Midwives, they are being exposed to a different appreciation and understanding, that it’s not about gender but about competence.”

Ocho recalled starting his career as a nursing assistant trainee at San Fernando General Hospital in 1981. At that time he only had two A-Level subjects but he walked into the office of then minister of health and local government, Kamaluddin Mohammed and said, “I understand that the Ministry of Health is in disarray and I’m here to offer my services.”

Mohammed sent Ocho to the chief nursing officer who told him they did not usually take males as nursing assistants but, a few weeks later, he got a call saying he was to start his training.

He became a qualified RN in 1987 and was sent for self-development in 1991. He earned a BScN in education from UWI in 1995; an MPH in international health from the University of Washington in 2005; an MPhil in sociology from UWI in 2007 and a doctorate in public health with an emphasis on public health and policy from the London School of Hygiene and Tropical Medicine in 2013.

He continued teaching during that time as well as through his 16 years in public health administration. From June to December 2014 he was the acting chief nursing officer in the Health Ministry, but in 2015 he returned to teaching exclusively when he became director at the UWI School of Nursing.

Ocho said he never experienced gender-related challenges in this field dominated by females.

He said the male nurses had a reputation of “running away” from the wards, sweet-talking their female colleagues, and providing them with moral support rather than actually working. As a result, when he completed his RN training, he never wore the male nurses uniform – a shirt jack. Instead he wore a tunic.

“I wanted how I presented myself as a male to be someone who was respectful, who was knowledgeable, who was competent. I wanted to change the image people had of male nurses.

“When it came to getting involved in patient care, nothing was too difficult for me. I found that generated a level of respect among my colleagues. From the start I believed I would make a difference as a male in the field of nursing.

“Apart from that, I saw myself as a gatekeeper for the profession, so when students came to the ward, teaching them was a big thing for me because I wanted them to understand the joys of this profession.”