Strengthening emergency care for pregnant women, newborn babies and children, including training in advanced maternity and neonatal care, obstetric anaesthesia and critical care
Implementing partner of UNICEF
In April 2019, MCAI became an implementing partner of UNICEF to work together on an obstetric and neonatal project based at Martha Tubman Hospital in Grand Gedeh County, Liberia.
This project will involve setting up, running and staffing a neonatal unit and providing emergency comprehensive obstetric and neonatal care at Martha Tubman Hospital. There will also be an outreach maternal health project to local community health facilities.
Latest data on the Liberian Task-Sharing Programme February 2018
Following a request from WHO Liberia, MCAI have prepared high and low resolution versions of the latest reports on the state of our obstetric and neonatal task-sharing programmes in Liberia.
Click here to view high resolution report
Click here to view low resolution report
Positive independent evaluation of MCAI’s work in Liberia
An independent evaluation organised by WHO and funded by Irish Aid has recently reported on MCAI’s obstetric and neonatal task-sharing programmes in Liberia, which are run jointly with the Ministry of Health and Social Welfare, UNFPA and WHO. The report is positive about the impact both programmes are having in saving the lives of pregnant women and their babies and recommends that both programmes be scaled up and rolled out throughout Liberia. You can read the report here.
Proposal to roll out a hospital-based, task-shifting approach to strengthen maternal and neonatal care in low income countries such as Liberia where there are hardly any doctors
One of the main problems in the provision of hospital care for pregnant women and newborn infants in low-income countries, particularly those in sub-Saharan Africa, is a lack of appropriately trained doctors who can care for patients most at risk of death or serious long-term harmful complications. Such complications include obstetric fistulae in women and adolescent girls who have experienced obstructed labour without access to immediate Caesarean section, and permanent, but preventable, cerebral palsy in infants where newborn care has been delayed, or performed incorrectly.
Emergency hospital obstetric and neonatal care frequently involves long periods overnight where doctors have to work extremely hard without sleep and where mistakes due to tiredness, can be fatal. Such pressures can usually be endured where there are sufficient numbers of well-trained doctors to provide adequate care, but in situations where doctors are scarce, the rotas required to provide life-saving care 24 hours a day, 7 days a week, are difficult to fulfill and many doctors become “burnt out” as a result. This situation often leads to doctors leaving the country, working only in well-resourced hospitals in cities rather than in rural hospitals, or undertaking private health work where overnight, front-line clinical care is minimal. Some doctors may also decide to accept offers of desk-based jobs from international organisations. The loss of doctors from front-line clinical care progressively makes the situation worse. It leads not only to a lack of quality care for patients, but reduced opportunities for junior doctors to become trained by senior experienced specialists in advanced obstetric and neonatal care. There is little doubt that this human resource problem is one of the most serious root causes of maternal and neonatal mortality in low-income settings.
Providing training in advanced obstetrics including abdominal surgery such as Caesarean section for experienced midwives
In February 2012, MCAI approached the Liberian Ministry of Health and the World Health Organization (WHO), proposing a collaborative partnership to reduce rates of maternal and neonatal mortality in Liberia. One aim was to address the shortfall in doctors by training experienced midwives in advanced obstetrics including abdominal surgery. In October 2012, a formal partnership – including a pilot project training two experienced midwives – was established. In September 2013, the Liberian Medical and Dental Council approved the provisional registration of the first two midwives to train as obstetric clinicians.
Strengthening hospital-based care for the management of newborn infants in Liberia using a task-shifting approach
6th September 2017
A small delegation visits CH Rennie Hospital in Kakata to evaluate the development of a neonatal hospital care unit
MCAI has now received a grant from the World Health Organisation to extend the task-shifting approach for hospital maternity care to provide basic hospital care for new-born infants. This care will include the main issues of feeding, temperature regulation, infection detection and treatment, jaundice management and the care of those with respiratory failure (including nasal CPAP but not assisted ventilation). Low birth weight and preterm babies are common, and the special care needed for this group will also be established.
We aim to teach in the first instance 9 senior nurses, midwives or physician assistants in 2 busy public hospitals in Liberia. Training will last 1 year and involve a combination of apprenticeship-based ward care and small group tutorials.
The post is suitable for an advanced neonatal nurse practitioner, a general paediatrician, or a trainee paediatrician interested in working in Liberia with a key role in delivering the educational programme and supporting clinical services. The post could comprise job-sharing and minimum periods in Liberia of 2-3 months at one time.
If you are interested in this work please contact MCAI for more information. Basic, secure accommodation close to the hospitals, high quality travel/medical insurance and a license to practice through the Liberian Medical and Dental Council will be provided. Flights and a daily subsistence allowance may be available depending on circumstances.
Professor David Southall OBE, MD, FRCPCH
Honorary Medical Director MCAI, 1 Columba Court, Laide IV22 2NL, UK
0044 (0) 7710 674003
From left to right:
Dr. Kumblytee Johnson, Medical Director, CH Rennie Hospital
Adeyemo Kola, Advanced Neonatal Nurse Practitioner and Trainer, CB Dunbar Hospital
Dr. Jean Junior, Paediatric Resident University of California Hospital San Francisco (UCSF) and Trainer CB Dunbar Hospital
Christina Nyenabo, Trainee neonatal hospital practitioner, CB Dunbar Hospital
In May 2016, MCAI was registered as an NGO in Liberia. This development means that MCAI Liberia is now a distinct entity.
The Directors of MCAI Liberia are: Dr Obed Dolo, Professor David Southall, and Dr Rhona MacDonald.
Jeremiah Akoi (BBA MBA) is MCAI Liberia’s Financial Manager. Amos Davis (BSc in Business Management) is MCAI Liberia’s Programme Manager. The address of MCAI Liberia is House 13, Phebe Hospital, Suakoko, Bong, Liberia and the Enterprise Number is 051730402.
Strengthening the hospital care systems
Since February 2012, MCAI has provided large amounts of essential drugs, medical and surgical supplies and surgical instruments to the hospitals in which we have been working. MCAI has also provided emergency equipment such as portable ultrasound scanners, oxygen concentrators, pulse oximeters, nasal CPAP and neonatal platform incubators for resuscitation. With support from UNFPA we have provided 500 MCAI textbooks and 1500 MCAI pocketbooks for doctors and other front-line health workers in all hospitals in Liberia.
Short 3-day courses in managing emergencies in pregnant women and adolescent girls and in the newborn infant in Bong County
MCAI was one of three UK medical charities awarded a THET/UKAID grant for a ground-breaking project to improve maternal and neonatal mortality in Liberia.
Between 1st September 2013 and 31st February 2014, alongside our partners ALSG, MCAI introduced training in emergency maternal and neonatal care (EMNH) for 171 midwives, nurses, physician assistants, nurse anaesthetists and doctors.
Deputy Minister of Health for Liberia concluding the first 3 day Medical Ethics course
Courses in medical ethics and professional standards for health workers in hospitals throughout Liberia
In 2015, MCAI was invited by the Ministry of Health in Liberia to undertake a 3-day course in Medical Ethics and Professional Standards for 32 senior health officials and doctors. This course was held in Monrovia from the 5th to 7th August 2015 and undertaken by the Registrar of the Liberian Medical and Dental Council (LMDC), the Medical Director of CB Dunbar Maternity Hospital, MCAI's Honorary Medical Director and an international volunteer paediatrician from the UK.
MCAI’s aim, in collaboration with the LMDC, is now to introduce the training into every hospital in Liberia for health workers of all levels over the next two years. Check lists, guidelines, manuals and protocols to help improve professional standards will be distributed.
Read the course outline here.
Read the latest version of the manual of the Maternal and Child Friendly Healthcare Initiative (MCFHI).