Midwifery Coordination Alliance Team (MCAT) meetings are designed to provide the link between midwives in health centres and hospital staff provide to pregnant women provide the best possible care during delivery. Health centre midwives provide the bulk of initial maternal and child health (MCH) interventions, while complications require hospital care. Staff at health centres and hospitals must communicate regularly in order to have a functioning referral system.
Ghim Sorn, 48, has been working as a midwife for the last 19 years. She works in a health centre 79 km from Smach Mean Chey Operational District in Koh Kong province. She is really keen on her job, although she had to face many complications and challenges due to the limited capacity of her health center or lack of confidence on how to treat a woman with eclampsia or post-partum haemorrhage (PPH) and the idea of referring patient to the hospital has never been an easy decision to take.
“Fortunately, the Midwifery Coordination Alliance Team (MCAT) meetings started in July 2014- with the support of CARE and GSK 20% reinvestment program – and it has been having a huge impact for me and all midwives” Sorn added.
MCATs play an essential role in strengthening the capacity of midwives at both the health centre and referral hospital level through clinical skills training. During MCAT, the first session reflects on the findings and gaps of recent supervisory visits and plenary discussion on the clinical issues midwives collected during the quarter and in the afternoon they receive clinical skills training. Having the opportunity to share and build their network among midwives has been one of the many successes of this initiative.
Sorn attended many clinical skills training sessions covering the use of MgSO4, post-partum haemorrhage (PPH), Antenatal Care (ANC), breast feeding, labour care using partograph. The approach and structure of MCATs allow them to learn also practical skills and share their experience with others. Supervisors visit midwives quarterly to provide on-the-job training and to practice our skill through live consultation or using a mannequin, which help build their confidence, experience and motivation. At the end of supervision, they identify issues (clinical and non-clinical) and provide feedback to midwives and health center chiefs.
An action plan and a specific plan is assessed to be followed up in next visits. This approach gives us the right mindset to the health center staff.
She feels more confident now and she understands the interventions to put in place when necessary. In early 2015, she had to intervene with a case of pre-eclampsia. She called the doctor at t he provincial referral hospital to request support and information. She followed the instructions and the pregnant women gave birth to a premature child named Lim Chenda. She saved mother and child from dying.
MCAT group meetings represent an important part of midwives on the job training and education and they really appreciate the confidence that those meetings build in their skills.
These activities are part of Partnering to Save Lives, and Improvements in Health Service Delivery in Remote & Marginalised Communities which is funded by the Australian Government and GlaxoSmithKline.