Midwives in Training: Commitment, Competence, Confidence
by Marie M. Marcelin, RN
Today, in Nursing, a midwife is respected as a healthcare professional who is trained to provide safe care for women throughout the prenatal and postnatal periods. Midwives have a special position of honor in scripture because of their notable character trait – obedience to the Lord.
“The king of Egypt said to the Hebrew midwives, whose names were Shiphrah and Puah, ‘When you are helping the Hebrew women during childbirth on the delivery stool, if you see that the baby is a boy, kill him; but if it is a girl, let her live.’ The midwives, however, obeyed God and did not do what the king of Egypt had told them to do; they let the boys live. Then the king of Egypt summoned the midwives and asked them, ‘Why have you done this? Why have you let the boys live?’ The midwives answered Pharoah, ‘Hebrew women are not like Egyptian women; they are vigorous and give birth before the midwives arrive.’ So God was kind to the midwives…”(Exodus 1:15-20)
Midwives remain in this honorable position before the Lord, which is also illustrated through this remarkable collaborative project training midwives by three CCIH members: Helping Children Worldwide (HCW), Healey International Relief Foundation (Healey IRF), and the Christian Health Association of Sierra Leone (CHASL). Pay close attention to the following interview with a phenomenal team of women who planned this project: Yasmine Vaughan, Technical Advisor for Global Health and Missions, HCW; Josephine Garnem, Executive Director for Healey IRF; and Victoria Middleton, Director of Development and Government, Healey IRF. They share their story and how it drives their commitment “to ensure no woman dies bringing life into this world and that every baby makes it to their 5th birthday.”
What was the purpose of the project between HCW, Healey IRF, and CHASL?
Yasmine: The purpose of this project is to train midwives. The World Health Organization has really moved towards this Midwifery Model of Care in terms of how they are approaching Maternal Health. They think that skilled midwives can avert more than 80%, not just maternal and newborn deaths, but also stillbirths and care for sexual and reproductive health… We wanted to do this training to increase the confidence and competence in midwives.
Photo: One of the National Master Trainers simulates a delivering mother with a Mama Natalie strapped to her belly while the other Trainer advises the participants on her skills practice.
Tell me a little about the flow of training. How many days did it last and what format or technology did you use?
Yasmine: It was an in-person training, and was the second iteration of the training that we’ve done. This time we did it in Kenema in Sierra Leone at the newly-opened School of Midwifery. The format was a two-day orientation for rising trainers, five days of training with lectures followed by skills practice each day, and an opening morning session on a particular topic that we thought would be relevant to all of the trainees, such as self care, mental health, and respectful maternal care.
How did the partnership among the three organizations emerge?
Yasmine: I connected with the Healey Foundation at the CCIH Conference in 2021, it was a virtual conference year. Healey’s Former Executive Director, Ben Parra, posted in the chat that they did work in Sierra Leone and we exchanged messages. The friendship grew from there. At that time we were starting our own network of global health organizations called Together for Global Health, and I invited Healey to join, and he said, ‘I would love if Josephine joined as well, because she has her own work that she is doing with another organization in Sierra Leone.’ She joined and the network grew from there.
Victoria Middleton: I just want to give a shout-out to CCIH for helping with these collaborations and connections, because as Yasmine said, we meet at these conferences, and I think CCIH’s 30×30 (Health Systems Initiative) really helped people start thinking about collaborating and what they can do in health systems strengthening.
Photo: A participant demonstrating neonatal resuscitation
What methods did you use in training?
Yasmine: We have nurses, midwives, and physicians. Our lead trainer is Dr. Mariama Massaquoi, a Family Medicine Physician with a focus in OB. We paired them up with National Master Trainers who are certified as trainers in the curricula with international nurses and midwives from the United States and Canada. We have them work together, putting pairs into each classroom. There are posters that break down the action plan for a particular procedure. Then there are these practice simulators that are provided by Laerdal Medical, which are called “Momma Natalie” and “Baby Natalie” and they simulate the different scenarios of hemorrhage and neonatal resuscitation.
Josephine: The trainings were very hands-on. We have very small groups, with a maximum of seven participants to two trainers, sometimes ten when we had a very big group.
Photo: Two Midwives posing with one of our International Trainers as they practice repairing cervical tears.
What subjects did you choose for the training and how did you choose the subjects for the training?
Yasmine: This year we added two new curricula on Quality Improvement at the direction of the Ministry of Health. However, the main focus was on these two particular curricula: 1. Bleeding After Birth – comprehensive hands-on training designed to equip midwives with the skills to recognize, prevent, and manage postpartum hemorrhage, which is the leading cause of maternal mortality. and 2. Essentials of Newborn Care, which is focused on newborn resuscitation and care their first days of life.
Josephine: We also have a WhatsApp group that is very active where the participants will post what they have done in the facilities, trainings that have happened, and interventions that they have done that have saved lives. That is monitored by us every day.
Photo: The entire planning team for the conference, including trainers, support staff, and representatives from the Ministry of Health and Sanitation and the Kenema School of Midwifery.
What were the measures to determine if the objectives of this project would be delivered successfully?
Yasmine: The Essentials of Newborn Care from WHO and The Helping Mothers Survive have their own metrics to determine if participants are certified in the particular curricula. There are knowledge checks: Pre- and Post-tests. The most important part is the Hands-On; there are skills checks or Observed Structured Clinical Evaluation (OSCE).
What final thoughts would you like to share of your personal experience in the completion of this project?
Josephine: Transformative systems change is never the work of a single individual or organization. When a shared vision is put into motion, the right partners often rise to meet it—and it’s truly powerful to witness how seamlessly organizations can align when collaboration is rooted in mutual respect. We are grateful and fortunate for this. Our approach centers on genuine partnership: we see the Ministry of Health, nurses, community members, and every collaborating entity not as beneficiaries, but as true partners – co-creators. We do not come in with all the answers; rather, we listen and learn. These partners are essential stakeholders who often hold the most relevant and sustainable solutions.
Yasmine: My personal experience as a part of the completion of this project is to see what an honor it is to work with such amazing and powerful women. It’s an amazing group of people that are committed to ensuring that no woman dies bringing life into the world and that every baby makes it to their 5th birthday.
In the photo at the top, participants in the midwifery training session meticulously walk through the procedure’s action plan. These plans are designed to reflect realistic steps that midwives can take in low-resource settings.