EAS Journal of Nursing and Midwifery
Abbreviated Key Title: EAS J Nurs Midwifery
ISSN: 2663-0966 (Print) & ISSN: 2663-6735 (Online)
Published By East African Scholars Publisher, Kenya
Volume-4 | Issue-6 | Nov-Dec -2022 | DOI: 10.36349/easjnm.2022.v04i06.004
*Corresponding Author: Florence Mbuthia 196
School of Nursing and Midwifery, Dedan Kimathi University of Technology, Kiganjo/Mathari, B5, Nyeri, Kenya
Original Research Article
Opportunities and Challenges of Advanced Practice Midwifery (APM)
in Kenya: A Discussion Paper
Florence Mbuthia
1*
, Joyce Jebet
2
, Elijah Kirop
3
1
School of Nursing and Midwifery, Dedan Kimathi University of Technology, Kiganjo/Mathari, B5, Nyeri, Kenya
2
School of Nursing Sciences, University of Nairobi, University Way, Nairobi, Kenya
3
School of Nursing and Midwifery, Moi University, Eldoret,Kenya
Article History
Received: 12.10.2022
Accepted: 19.11.2022
Published: 24.11.2022
Journal homepage:
https://www.easpublisher.com
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Abstract: Background: The high maternal and neonatal deaths remain a global
concern especially in Low- and Middle-Income Countries. This is largely
attributed to the limited skilled workforce including midwives who are required to
offer quality maternal and neonatal care. Advanced Practice Midwifery (APM)
training has been highlighted as critical in achieving high-quality maternal and
neonatal care in all settings and countries. In Kenya, the APM training is at the
initial stages, having been launched in May 2022. This paper presents the results of
a literature review regarding opportunities and challenges for the APM training
and practice with a goal of availing information to any institution willing to begin
the program in Kenya and other LMICs. Methodology: A descriptive overview
was undertaken through a rapid literature review of the relevant local and
international literature to highlight the opportunities and challenges for the APM
training and practice based on the Kenyan Context. Results: The APM training and
practice has expansive opportunities such as the increased demand for quality care
and reduced cost services, supportive policies, advances in technology, profession
recognition and regularisation of the training and availability of midwives trained
at lower levels. The challenges that the APM training is likely to experience
includes; Lack of expert trainers, technological challenges, workload challenges
due to the high population in need of the services and clinical environment
challenges. Conclusion: APM training and practice has enormous opportunities
despite the challenges that may be experienced. Therefore, for any institution
preparing to start the APM training, there is need to exploit the existing
opportunities and address the likely challenges to ensure the APM training and
practice meets the desired outcomes.
Keywords: Advanced Practice Midwifery, Midwife, Opportunities, Challenges.
Copyright © 2022 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.
INTRODUCTION
Maternal and neonatal morbidity and mortality
remains a global burden and a public health concern,
particularly in sub-Saharan Africa where maternal
mortality still remains significantly high despite
numerous efforts and/or interventions (WHO, 2019).
This has been compounded by inadequate workforce,
including lack of skilled attendance especially
midwives thereby hindering access to quality midwifery
care (United Nations, 2019). Globally more than one
million midwives are required who should be well-
trained, skilled, and motivated midwives to help evert
over 85% of the deaths (UNFPA, 2022). The roles of
midwives in any given society cannot be
underestimated. From time immemorial midwives have
been highly regarded and respected in providing care
that result into optimal health outcomes (Walker et al.,
2014). Midwifery practice has been highlighted as
critical in achieving high-quality maternal and neonatal
care in all settings and countries (Schober, 2020).
Midwives across the globe practice autonomously to the
full scope of their practice. With continuous acquisition
of knowledge and skills, they gain experience and are
able to function at an advanced level of practice (Smith
et al., 2010). It is paramount for any government to
recognise this advanced role that midwives play and
equip them with training that will enable them remain at
per with other allied professional albeit being
autonomous.