Midwives, the frontline caregivers for moms and babies, significantly contribute to improving maternal and newborn health.[1] This is no different in Tajikistan.
In Yovon, the largest district in Tajikistan’s mountainous Khatlon region, life is not easy. Compounding the hardship, jobs are scarce, and many men have migrated to other countries to find work and earn income to send back to their families. With their husbands gone, women take on an additional strain to raise children alone. In addition, in the absence of their husband, the culture dictates giving decision-making to the mother/father-in-law on most aspects of a woman’s life, including maternal and child care.
Midwives of Yovon know firsthand about the exponential challenges women face due to migration and the subsequent loss of decision-making power. They know they must work even more closely with the community to connect the medical system with the mother/father-in-law so women can receive necessary maternal care, including antenatal care (ANC) and a safe facility for the birth.
USAID Healthy Mother, Healthy Baby (HMHB) Activity formed a pool of 22 locally trained midwives. They have become Yovon’s master midwifery trainers. To improve the skills of the midwives in Yovon, these master trainers conduct regular classes. Sharifamo Gulomshoeva, a 43-year-old native of Yovon, has proven herself to be one of the most dedicated of all the master midwives.
Sharifamo was the winner of the 2021 USAID Midwife Award in Bokhtar in the Khatlon region. HMHB devised this competition to allow midwives to demonstrate their knowledge and expertise. Twelve teams from facilities in Khatlon came together to compete and demonstrate their proficiency in ANC and nutrition for pregnant women, breastfeeding, counseling, contraception and reproductive health, and techniques to encourage use of birth facilities for births and emergency obstetric care. Sharifamo and her team from Yovon demonstrated the highest level of preparedness among the 50 midwives who participated in the contest. During practical assessments, in which the midwives had to respond to a complex birth scenario, Sharifamo and her energetic team managed to accomplish their tasks most quickly and with the highest precision to comply with national clinical guidelines and protocols.
“I dreamed of being a midwife since childhood; this dream has come true. Now, I can help the birth of a new life and protect mothers and babies from complications by providing timely assistance. Every time I hear the first cry and the first breath of a baby, I am filled with strength and pride. I have participated in many midwifery trainings, but the HMHB training of trainers has changed my life. After I received my trainer certification, I felt compelled to pass on my knowledge and experience to my colleagues, especially young midwives,” Sharifamo says.
After receiving the 2021 USAID Midwife Award, she was promoted to senior midwife and trainer of all midwifery staff of the Yovon maternity ward. There, she supervises up to 30 midwives in the maternity ward. She also provides training on management of bleeding during pregnancy, childbirth, and the postpartum period to 14 midwives from remote villages. These midwives work independently, providing care to women in labor in difficult conditions—sometimes without access to electricity, water, or first aid medical equipment. Sharifamo trains midwives from remote villages on the proper management of childbirth, timely prevention of bleeding, timely referral in case of complications, and the importance of ANC visits and facility births.
Sharifamo serves as a role model for other midwives and urges them to follow their calling to help mothers and newborns: “Thanks to Sharifamo, I learned lot and feel more confident in my village when I help pregnant women,” said Navruzmo Alieva, a midwife from Navobod village. “Before, I was afraid to deliver babies and sent everyone to the district center, but now I can help in childbirth and the postpartum period. I try not to miss classes, even though I live 28 km away from the center. This training is building my skills and confidence and helps save the lives of our women and children.”
To expand midwifery capacity building, HMHB, in collaboration with the National Midwifery Association, is helping scale up this master midwife trainer approach to strengthen practical skills and promote to communities and facilities the important roles and responsibilities of midwives. Together with her midwife colleagues, Sharifamo’s helping hands ensure the health of Tajik moms and babies.
ENDNOTES:
[1] The World Health Organization (WHO), International Confederation of Midwives (ICM) and the United Nations Population Fund (UNFPA) identify midwives as a critical cadre to improve maternal care worldwide.
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