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Building relationships between local midwives to save the lives of mothers and infants

Horn Sokin, 26, has been a midwife in Sre Ambel district for just over a year. After learning the theory of midwifery during her studies, she found that when working in real life she often had practical questions about specific cases that were outside her experience. When she first started at the health centre, Sokin had no support system to help her, as she had no contact with other midwives in the area and no relationship with hospital staff when she needed extra assistance.

Sokin delivers around five babies each month and sometimes has to deal with complicated cases, whether this is a breech birth, post-partum bleeding or other severe issues. This means that Sokin attends a number of births which require special attention to avoid losing the mother or the child.

Attending Midwifery Coordination Alliance Team (MCAT) meetings, which started in July 2013, has had a huge impact on Sokin and her work. Each quarter she meets with other midwives and doctors from health centres, referral hospital, operational district and provincial health department in the area, allowing them to share their experiences and discuss best practices with other medical staff. Having the opportunity to build these relationships face-to-face has been key to improving the work of the midwives in the area – Sokin can now seek extra support immediately when problems arise by contacting other medical staff for their input.

When cases are serious enough to require referral to hospital, she now knows exactly who to contact without spending time consulting her colleagues. Having discussed the challenges they all face as health professionals at the MCAT meetings, Sokin says the hospital staff have changed their attitude towards midwives from the health centres and are much more keen to work together to provide greater service to mothers in the area.

The MCAT meetings are also providing clinical skills training, allowing midwives to refresh their knowledge and gain a deeper understanding of conditions such as pre-eclampsia, eclampsia and post-partum hemorrhage. Medical staff are keen to update their skills and knowledge and the project has helped by organising quarterly supervisions from the Provincial Health Department, Operational District and Referral Hospital. The supervision gives each midwife one-on-one support while they are working in the health centres and allows them to ask any follow-up questions from the skills training. The supervision team then meet with each health centre chief to provide feedback and suggest areas for further development, encouraging health workers to continuously improve the services they provide.

Sokin has learned the benefits of the Midwife notebook the GSK project provided to her, which gives her a separate folder for recording health related information, such as encountered issues, new clinical techniques, and updated health information. This makes it easier for her to remember all the challenges and questions raised at the health center so she can seek guidance from others at the next MCAT meeting. This change has allowed Sokin to more easily track the progress of her activities, follow up on issues, and seek technical input and support.

For Sokin herself, networking with other midwives in the area has helped build her confidence at the start of her career. She has observed that improving her skills has led to better trust among community members and this has resulted in more women going to the health centres to deliver their babies.

The MCAT meetings have literally been a lifesaver for many midwives, helping them to improve their knowledge and support each other to save the lives of mothers and infants. The success of the project has already become known in the area and other operational districts in Koh Kong are asking whether they can implement MCATs for their midwives.

For Sokin, she hopes that these will continue so she can carry on improving her skills throughout her career.

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