Helping midwives in Ghana to reduce maternal mortality

This article describes work undertaken in Ghana with Kybele, a multidisciplinary humanitarian organisation. Kybele is dedicated to improving childbirth safety worldwide, by improving processes that will reduce maternal mortality. The role of the author, as the midwife team member, was to work alongside doctors and midwives in a busy maternity referral hospital in Accra, Ghana. Review of the history of maternal deaths, and observing and working alongside the midwives revealed a heavy workload, cramped and disorganised space, poor decision making and inadequate referral systems. This project provided opportunities for small group work, supported managers and targeted teaching to enable the Ghanaian midwives to share their beliefs about their role, understand the challenges and identify ways to improve standards of care for women. The midwives decided on four key areas for improvement: monitoring women using the partogram, improving professional accountability by introducing patient allocation, improving the labour ward environment and developing leadership skills. The partnership working style and ongoing support that are key features of the Kybele model will continue to assist the project and monitor progress.