ICM Standard Equipment List for Competency-Based Basic Skills Training in Midwifery Schools Background

 

The Investing in Midwives (IMP) and others with Midwifery Skills Initiative was formally launched in March 2009 with a mandate to strengthen midwifery education, regulation and associations towards improvements in maternal and newborn health.

 

IMP works through national health systems in underresourced settings in Africa, Asia, Latin America and the Caribbean to increase midwifery capacity to integrate the full continuum of maternal health care in national health systems.

 

The focus of the programme is on planning and scaling up midwifery and other mid-level providers in response to the World Health Assembly call for a decade of action for Human Resources for Health in 2006 to improve on health indices especially MDG 5.

 

Currently the IMP is being implemented in 12 African and 6 Asian countries including Benin, Burkina Faso, Burundi, Chad, Cote d’Ivoire, Ethiopia, Ghana, Madagascar, Uganda, Zambia, Djibouti, North Sudan, South Sudan, Afghanistan, Bangladesh, Nepal, India and Pakistan.

 

There are expressions of interest for expansion to include other countries in Africa and Asia such as Liberia, Malawi, Nigeria, Sierra Leone, Cameroon and the Democratic Republic of Congo due to their poor maternal health indices.

 

The envisaged outcome of the IMP is an improved working environment within countries where an increased number of appropriately educated midwives and others with midwifery skills function at all levels including policy making to accelerate progress towards MDGs 4 & 5 at country and regional levels.

 

It is in pursuance of this outcome and also to contribute towards ICM’s vision of a world where every childbearing woman has access to a midwife's care for herself and her newborn that the IMP set out to conduct country needs assessment of midwifery to inform strategic planning in over 12 countries.

 

Lack of teaching-learning materials was one major finding of the assessments and this necessitated that the ICM generate a standardised compendium of models, equipment and teaching aides to inform UNFPA offices in the programme countries in their bid to purchase teaching-learning materials to improve on the teaching of practical skills among student midwives.

 

Note to the User This document has been developed as a standard reference guide to inform programme countries and midwifery-related programmes on the basic set of models, equipment, consumables, reference books and learning materials (TLMs) for midwifery education and training.

 

These resources are required for building the competencies of student midwives to the level of proficiency needed to graduate from country–accredited educational institutions for licensure and registration to practice midwifery.

 

The contents of this document has been set out in four parts:

 

1) a composite list of all models, equipment, logistics, consumables and TLMs needed to set up a Skills Laboratory for midwifery practical training;

 

2) a resource and specification list for selected resources, and

 

3) a composite set of materials organised into teaching/learning packages. The content of these three lists is then reflected in

 

4) a final comparison of the seven ICM (2010) approved essential competencies for basic ICM Standard Equipment List for Competency-Based Basic Skills Training in Midwifery Schools Page 8 midwifery practice, with the resources that would be necessary within competency-based midwifery education programmes that cite the ICM competencies as expected learning outcomes.

 

According to the ICM (2011) definition, a midwife is: “A person who has successfully completed a midwifery education programme that is duly recognized in the country where it is located and that is based on the ICM Essential Competencies for Basic Midwifery Practice and the framework of the ICM Global Standards for Midwifery Education; who has acquired the requisite qualifications to be registered and/or legally licensed to practice midwifery and use the title ‘midwife’; and who demonstrates competency in the practice of midwifery.”

 

It is therefore important and facilitative that the TLMs are presented by competencies to aid the assembling of materials for students’ practical training. ICM is confident that users will find this document very useful to midwifery pre-service improvements. One area of possible need to the user which has not been provided in detail is the actual specification per each item. Where possible we have indicated the product manufacturers or distributer to enable you link up for current specifications.

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2.0 ICM Standard Equipment List for Competency-Based Basic Skills Training in Midwifery Schools

 

2.1 Composite Essential Teaching-Learning Materials

 

LIST ONE:

Anatomical Models

1. Zoe or Mama Natalie Models Non-Pregnant Pregnant – simulator for 1st, 2nd and 3rd trimesters Pelvic model

2. Childbirth simulator / NOELLE Maternal and neonatal birthing simulator

3. Condom model on base

4. IUD hand held model

5. Anatomic models for injections in arm, buttock and thigh) (May use soft doll or small piece of fruit)

6. Pregnant abdomen model (for palpation – if Zoe model is not available)

7. Breast (and breastfeeding) model

8. Bony pelvis (hard: landmarks identified)

9. Foetal skull (landmarks identified)

10. Foetal baby, umbilical cord and placenta for vacuum delivery

11. Uterus and placenta models

12. Cervical replicas (for IUD insertion)

13. Cervical dilation model (plastic)

14. Adult resuscitation doll/model

15. Newborn resuscitation doll/model

16. Foetus

17. Perineum cutting and suturing training simulator (or 6 inch sponge blocks)

18. Small ball (cricket, baseball, tennis) & socks for assessing dilatation of cervix LIST TWO: Equipment

19. Implant insertion/removal kit

a) Trocar and cannulae

b) Scalpel and holder

c) Blade

d) Mosquito artery forceps (curved and straight)

e) Tweezers Alternatively: Kit purchased from order@mariestopes.org.uk (contains small Rampley sponge

holding forceps, cup/bowl (Gallipot),

 

2 curved mosquito forceps, scalpel handle #3) 20. IUD insertion kit

a) Tenaculum (atraumatic and/or single tooth)

b) Uterine Sound

c) Bi-valve vaginal speculum

d) Ring forceps e) IUD drive tube ICM Standard Equipment List for Competency-Based Basic Skills Training in

 

Midwifery Schools Page 10

21. Light source (examination light or well lit room)

22. Adult weighing scale

23. Infant weighing scale

24. Adult blood pressure apparatus (including stethoscope) 25. Newborn blood pressure apparatus (optional)/stethoscope 26. Wall clock to reflect seconds 27. Reflex hammer 28. Pen light/small flashlight 29. Measuring tape 30. Tongue depressors 31. Thermometer 32. Vaginal speculums – various sizes 33. Receiving bowls (various sizes, for solutions and for collection of specimens)

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34. Graduated measuring jug

35. IV administration stand/pole

36. Tourniquet

37. Foetoscope (foetal stethoscope)

38. Doptone (if available)

39. Cord scissors

40. Curved mayo scissors (5.5 in. or 14 cm.)

41. Large straight scissors

42. Ring forceps 9.5 in. or 24.2 cm. (sponge holding forceps-straight)

43. Kocher 140 mm. straight (for amniotomy) and/or amniotomy hook

44. Long dressing forceps

45. Needle holding forceps

46. Needle extender

47. Dissecting forceps/pickups (plain and rat-toothed)

48. Large haemostat (7 inch artery forceps)

49. Episiotomy kit (stainless steel container with some of the items on this list)

50. Delivery Kit (box/bag containing some of the items on this list)

51. Transport incubator (or box fitted as simulation)

52. Ambu bag (adult and paediatric) with masks

53. Suturing set (box/bag containing some of the items on this list)

54. Manual Vacuum Aspirator (MVA Plus)

55. Set of dilators (tapered dilators, such as Pratt or Denniston, are best)

56. Strainer for tissue inspection

57. Clear containers or basin/plastic buckets (for decontamination)

58. Bedpan with cover

59. Delivery bed (patient bed, or delivery table, with privacy screens)

60. Examination table with stirrups

61. Examination stool (adjustable height)

62. Equipment cart with wheels

63. Two chairs and tables

64. Running water and sink

65. Sterilization kit or autoclave

66. Dustbin

67. Microscope and supplies (optional)

68. Haemoglobinometer (optional)

69. Vacuum extractor (optional) LIST THREE: Consumables

 

70. Family Planning Samples a) Male and female condoms b) Implant (e.g., Jadelle and Implanon; others as available in country) c) Injectables (Hormonal: e.g., Depo Provera, Noristerat, Norigynon) d) IUD (e.g., Copper T 380A, Mirena) e) Pills (e.g., combined, progestin only – may be simulated)

 

71. Hand sanitizer a) alcohol rub (may be prepared using glycerine-2mls and methylated spirit100mls of 70-80%) b) soap (liquid or cake)

 

72. Iodine/Aqueous solution of iodine (diluted) or other antiseptic solution

 

73. Lubricant – water soluble (e.g., silicone)

 

74. Swabs and/or wipes (various) a) cotton wool swabs b) gauze swabs c) alcohol wipes

 

75. Tissue paper (facial/nasal/toilet)

76. Examination gloves (clean, sterile and HLD; both disposable and reusable)

77. Urine test kit for protein & glucose (or reagents for laboratory testing)

78. Test materials for haemoglobin

79. Cytology kits (per country specification for Pap smears)

80. Acetic acid reagent (for VIA)

81. Urethral catheter

82. Suction tube (adult and pediatric sizes)

83. Intravenous supplies a) infusions (various volumes and types – may be simulated) b) giving set c) cannulae/catheters (various sizes) d) adhesive tape/elastoplast

84. Identification bands (mother and baby)

85. Newborn supplies (e.g., clothing, caps, diaper)

86. Towels and bed linens 87. Examination gowns 88. Waterproof sheet (mackintosh)

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89. Disposable towels/drapes (for sterile field)

90. Cord clamps (disposable)

91. Safety box for sharps

92. Cotton or woollen blankets/sheets – for mother and baby

93. Expired sutures selected for demonstration (NOTE: should be the correct size and type (absorbable) e.g. chromic 2-0 )

94. Syringes (various sizes)

95. Needles (various sizes)

96. Mucus extractor

97. Personal protection equipment a) goggles b) aprons/gowns – plastic c) rubber or paper boots (optional)

98. Blood sample bottles

99. Wound dressings

100. Decontaminant (chlorine based) solution (0.5% chlorine) LIST FOUR: MEDICINES/INJECTABLES (As allowed per country-based Essential Drug List) For teaching purposes only an empty package or vial is needed, labelled in the dosages in which the drug is supplied in country (for purpose of dosage calculations rather than drug administration)

101. Anti-anxiety medication or other light sedation

102. Analgesia medication (e.g., acetaminophen, ibuprofen, pethidine)

103. Uterotonics (i.e., oxytocin, ergometrine, syntometrine, misoprostol)

104 Mifepristone (optional)

105. Broad-spectrum antibiotics

106. Tetanus toxoid

107. Antimalarials

108. Haematimics

109. Antihypertensives and anticonvulsants (e.g., MgSO4, diazepam)

110. Local anaesthetics (e.g. xylocaine, lignocaine)

111. Infant eye medications (e.g., silver nitrate, tetracycline)

112. Infant medications (e.g., vaccines, Vitamin K)

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LIST FIVE: LEARNING MATERIALS Charts/Visual Depictions/Country Based Forms

113. Female reproductive anatomy

114. Male reproductive anatomy

115. Normal changes of pregnancy

116. Prenatal discomforts ICM Standard Equipment List for Competency-Based Basic Skills Training in Midwifery Schools Page 13

117. Foetal development

118. Stages of labour

119. Cervical dilation and foetal descent

120. Mechanisms of birth (vertex & breech)

121. Malpresentations

122. Episiotomy a) How to perform an episiotomy b) How to anaesthetise the perineum for episiotomy and repair of tears c) Different types of episiotomy

123. Perineal and cervical tears (technique for repair)

124. Adolescent growth and development (e.g., Tanner stages)

125. Newborn resuscitation protocol

126. Adult resuscitation protocol

127. Charts or video on infection prevention procedures

128. Charts/posters on national referral systems and appropriate referral form (local)

129. Midwives code of conduct

130. Women’s rights (society and health care system responsibilities)

131. Contraceptive methods (e.g., FP Global Handbook for ProvidersUSAID/WHO/Johns Hopkins University)

132. Family planning flip chart 133. Lactational Amenorrhoea Method (LAM)

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134. Standard days method beads

135. Gestational age calculator (pregnancy wheel)

136. Maternal health records book/antenatal card/file (consistent with local practice)

137. Partograph (WHO: Need for country decision on version of partograph to use)

138. Country based client records/forms a) antenatal records b) intra-partum care records c) family planning client forms/ folder/cards d) resuscitation record forms Books/Manuals/Videos

139. National FP protocol (local production)

140. Global Handbook on FP

141. Balanced Counselling Strategy Cue cards (Population Council/Frontiers)

142. CDs or documentary on local cultures and tradition (WHO/World Education)

143. Job aides on alarm and transport for emergency care

144. Country-based algorithm depicting how to access emergency transport

145. Country-based algorithm on direct and indirect causes of maternal and neonatal mortality and morbidity 146. WHO IMPAC materials

147. Manual removal of placenta

148. Management of shoulder dystocia

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149. Bimanual compression of the uterus

150. Aortic compression

151. Breastfeeding/latching on

152. Woman Centered Abortion Care (W-CAC) and/or Woman Centered Post Abortion Care (W-PAC) manual (Contact Ipas)

153. Medical Abortion Training Curricula and IEC resources for providers and women (Contact Ipas) (optional/additional)

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