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Background of Programme:

Background and Context

The reduction of the high Maternal and child mortality in Lesotho ranks high among the national health priorities. To this end, following the development and implementation of the RMNCAH Strategy, Lesotho further developed the guidelines (ANC, FP &IPC) to guide the implementation of the key maternal and child morbidity and mortality reduction interventions. While the implementation of these guidelines contributed to the improvement in the coverage of essential reproductive, maternal, newborn, child and adolescent health and nutrition intervention packages, maternal mortality in Lesotho remains high, estimated at 566 deaths per 100,000 live births (2020 UN estimates). The leading causes of maternal deaths are obstetric hemorrhage, Post-partum sepsis, and eclampsia, all preventable direct maternal death causes (Lesotho Maternal Mortality Report 2015 - 2020). 

 

Midwives play a critical role in averting maternal deaths and morbidity; averting early newborn deaths. They play a critical role in managing Maternal (and perinatal) death surveillance and response; and preventing mother-to-child transmission of HIV. When Midwives are properly trained and authorized they can effectively provide comprehensive sexual and reproductive health information and services along the full continuum of care, including safe delivery and timely referrals; family planning counselling and services; antenatal/postnatal care; services to prevent and treat HIV, sexually transmitted infections and congenital syphilis; and the provision of adolescent reproductive health and GBV.  According to the State of the World’s Midwifery Report 2021 achieving universal coverage of midwife-delivered interventions by 2035 would avert 67 per cent of maternal deaths, 64 per cent of new-born deaths and 65 percent of stillbirths and would save an estimated 4.3 million lives a year. 

 

However, the 2019 Lesotho Midwifery gap analysis has identified gaps in midwifery education, service and regulation. Midwifery education does not meet global education standards and WHO Standards; regulation is not midwifery specific and midwifery scope of work is ill-defined.

In 2020 UNFPA supported Lesotho Nurses Training Institutions and National Health Training College CHAL – NTI and NHTC to remodel the Midwifery curriculum to be Competency based. The reviewed curriculum and its programmes were further aligned to the Lesotho Qualifications Framework (LQF) which is a prerequisite prior to submission for accreditation by the Council of Higher Education (CHE). Processes are underway to develop the teaching modules in preparation for the planned launch of this new curriculum in 2024.

 

The Lesotho Nursing and Midwifery council is a regulatory body leading the regulation system to incorporates the defined new curriculum competencies. The body is in the processes of developing a Midwifery Licensure however it has to update its tools – log book/register and an assessment tool monitoring the use of this log book/register. Some work has already been done by the International Consultant who supported with the development of Competency Based Midwifery Curriculum. The national team now has to adapt the document updated by that International Consultant and even add if need be nationally required competencies in those log books.

The midwifery logbook (register) is used by six (6) accredited nursing education institutions in Lesotho, and will comprehensively forge in quality care during pregnancy and child birth, thus contributing in reducing maternal and neonatal morbidity and mortality.

 

 

 

Purpose of consultancy:

The purpose of the consultancy is to facilitate the updating of midwifery log book / register used by six (6) accredited educational institutions in Lesotho and develop assessment tool or matrix to monitor the utilization of the register

 

Scope of work:

 

(Description of services, activities, or outputs)

The consultant will update and refine the Lesotho Midwifery log book (register)

Finalize the review by putting critical areas on a high order rank

Compile a comprehensive report to be shared with all the relevant partners, and prepare for the dissemination meeting with all the schools offering the midwifery programme.

 

The expected output

The consultant will submit:

  1. Revised Lesotho Midwifery log book (register)
  2. Final Assessment tool to monitor the utilization of the register
  3. Comprehensive report on the consultation process and how to use the assessment tool.

 

Duration and working schedule:

This assignment is for twenty working days

 

Place where services are to be delivered:

Home-based consultancy. All the work will be done with the Nursing and Midwifery Council. Both remotely and physically

Delivery dates and how work will be delivered (e.g. electronic, hard copy etc.):

 The work will be delivered electronically

  • Inception report within three days = 10%
  • Revised Lesotho Midwifery log book (register) on the 6th day= 50%
  • Assessment tool or matrix to monitor the utilization of the log book (register) on the 8th day = 30
  •  
  • Ccomprehensive report on the exercise   on the 10th day               = 10%

Monitoring and progress control, including reporting requirements, periodicity format and deadline:

The consultant shall closely work with the Lesotho Nursing and Midwifery Council.  She/he shall report progress to the UNFPA SRH Coordinator. On a final note the consultant will present the final product to the Head of Office UNFPA.  

Supervisory arrangements:

The consultant will be supervised by the SRHR Coordinator, in   close collaboration  with the Head Lesotho Nursing and Midwifery Council  

Expected travel:

There will be travel to the six nursing school. (Interviews with clinical supervisors, preceptors, midwifery nurse educators)

 

Required expertise, qualifications and competencies, including language requirements:

Education:

PHD or a Master’s degree in Midwifery Practice / Honours Midwifery Sciences

Knowledge and Experience: 

  • Midwifery education and expertise within the Midwifery profession
  • Working in midwifery administration or direct midwifery service as an advance practice registered midwife. 
  • Familiar with the International Confederation of Midwives policies
  • Knowledge of Lesotho Qualifications Framework and assessments

 

 

Inputs / services to be provided by UNFPA or implementing partner (e.g support services, office space, equipment), if applicable:

UNFPA will provide relevant support and guidance to ensure the successful undertaking of this consultancy, including administrative and financial support. 

 

Other relevant information or special conditions, if any:

Fluency in English; extensive knowledge on curriculum development , accreditation and assessments will be an added advantage