PRESENTED BY
SUSAN
 BACKGROUND
 RATIONALE
FOR INTRODUCING CMA?
 SUCCESSES
 CHALLENGES
 The
Millennium Development Goals 4
and 5 focus on improving maternal
and child health.
 In Malawi, Shortage and poor
retention of midwives is a challenge
for achieving these MDGs.
 This also contributes to a shortfall in
skilled birth attendants.
One
mechanism developed by
Malawi government to try to
increase skilled attendance at
birth, particularly in rural areas,
was the introduction of CMA
training
(18-month training programme).

CMA training started as a pilot program in 2011

25 female students enrolled at St. Joseph’s
College of Nursing and Midwifery

23 at St. Lukes College of Nursing and Midwifery

All deployed now

Currently enrolled at St. Joseph, MCHS,
Ekwendeni, st.Johns, Mulanje, Phalombe,
St.Lukes, Nkhoma.
To
reduce MMR currently
675/100 000 live birth and
neonatal mortality rate 33
per 1000 live births
To
increase skilled birth
attendants in the rural areas.
80%
of population live in rural areas
Challenges
to access health
services due geographical and
infrastructure problems
Many
midwives refuse to work in
rural settings
CMA
understands community
cultural background.
CMAs
stay in communities
CMAs
are adding to number
of skilled attendants in the
communities.
Curriculum
revised to
incorporate care of
emergencies
Mentorship
training for NMTs
to mentor CMAs
Support
from local
organisations.
 No
grass root level infrastructures
for CMAs to practice close to their
communities.
 Retention
of CMAs poses a challenge
as most of them are young and will
get married or want to continue
with education.
Mentors
not always available to
give the necessary support
Recruitment
done at a district
level and not at local level.

Curriculum still in draft form.
Provision
of infrastructures for
CMAs to practice in their
communities after six months of
working with a mentor- this will
improve access to skilled
attendance at grass root level.
Finalise
curriculum
Revise retention strategy
 ZIKOMO