Executive Summary:

Midwives, like nurses in Canada, work tireless hours caring for mothers/newborns. However, midwives in Uganda face additional challenges like understaffing, poor wages, and limited access to resources, decreasing their ability and motivation to perform their jobs effectively. Since 2011, Save the Mothers (STM), a Christian-based organization, has been operating the Mother Baby Friendly Hospital Initiative (MBFHI) within Ugandan health facilities, to ensure that women receive high quality, dignified, and respectful care throughout pregnancy/childbirth. MBFHI uses a 10-step framework to improve maternal/neonatal care, with 1 of the 10 steps–‘To nurture friendly and motivated healthcare professionals.’ Without an ongoing model to motivate midwives, STM is requesting funds to pilot a midwifery mentorship model within their 10 MBFHI hospitals.

The total number of health workers that will directly benefit from this mentorship model is 410, based on an average of 33 maternity midwives and 8 senior staff per hospital, including the hospital administrator, medical superintendent, senior nursing officer, and consulting physicians. The improved quality of care that will result from the mentorship model will indirectly benefit 227,164 mothers and 107,917 newborns, encompassing a catchment area of 5,395,833 based on 10 districts, using the 2014 Ugandan census.

The mentorship model will pair higher performing MBFHI hospitals with lower performing ones ($469; Dec 2017). 5–10 representatives from each hospital will be invited to attend an orientation about the model, including a meet-and-greet for partner hospitals ($6,000; Jan 2018). Peer mentorship activities will include 3–5 senior midwives visiting their partner’s hospital tri-annually to share best practices related to maternal/child health ($18,000; Feb/March, June/July, Oct/Nov 2018).

Each hospital will be given an empowerment fund to incentivize staff in providing high quality care ($20,000; March – Dec 2018; See Conclusion for criteria). Quarterly health symposiums will be conducted to recognize ‘best performing’ midwives and engage in clinical workshops to build their skill set ($23,000; Feb, May, Aug, Nov 2018). STM monitoring and evaluation will include: biannual key informant interviews with senior midwives and mothers, quarterly health worker questionnaires, quarterly empowerment accountability forms, and monthly performance tracking of maternal/neonatal deaths ($16,000; Jan – Dec 2018). Research manuscript will be submitted for publication (Jan 2019). The total amount of funds being requested is $83,469 CDN from Dec 2017 – Jan 2019.

The impact of the mentorship model will result in motivated, friendly, and trained health workers who provide high quality care for mothers/newborns. By recognizing the value of midwives and investing in their potential, the mentorship model creates a working environment to empower, inspire, and unite health workers in reducing maternal mortality in Uganda.

Measurable Outcomes:

• 90% of midwives will have reported increased clinical knowledge and skills related to best practices in maternal/child health after completion of the peer mentorship program by December 2018 through the administering of quarterly health worker questionnaires.
• 100% of midwives will have reported increased job satisfaction after completion of peer mentorship program by December 2018 through the administering of key informant interviews with midwives (pre and post).
• A research manuscript will be published in the Midwifery Journal on the findings of piloting a midwifery mentorship model within Ugandan health facilities by January 2019.

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