The role of context in midwifery
All midwives are given similar training, but practice may differ based on setting. Patricia Donovan reflects on her experiences as a midwife educator in Malawi, Seychelles and the UK
Lawton (1975) wrote that curriculum is a selection from culture. Any midwifery curriculum should be a selection from the local midwifery professional culture, so when we ask whether the content of a midwifery course in sub-Saharan Africa is the same as in the UK, the USA, Europe and other countries, the answer must be no. The experience of childbirth is different between countries and the health services are also very diverse. Having worked in Malawi, a resource-poor country; Seychelles, a middle income country; and the UK, a high-income country; the content of the curriculum is very different depending on the culture (both political and social) and the context of the midwifery care that is given. This article will give an insight into midwifery care in these countries and how it may differ from the standard midwifery texts that are used.
All midwifery courses use the International Confederation of Midwives (2013) midwifery competencies as a foundation, and curriculum developers map the midwifery course content against them. In addition, each country prepares the midwife to work in their own context and this requires different practices to those that may be seen in midwifery textbooks. The textbook that most midwifery courses use (especially ex-colonies) is Marshall and Raynor's Myles Textbook for Midwives, which is based on midwifery in the UK. Although there is an African edition, it is based in South Africa and appears to be an ‘add-on’ to the main content.
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