Background

The University of Manchester (UoM) and Lugina Africa Midwives Research Network (LAMRN) formally partnered in 2013 with the support of a THET multi-partnership grant. The purpose of this partnership was to develop a thriving midwifery research network to build research capacity and skills and improve evidence-based practice.

The partnership has been instrumental in development of LAMRN institutional midwifery research capacity in the six member countries (Kenya, Malawi, Tanzania, Uganda, Zambia, and Zimbabwe). During the two year project a series of workshops and alongside mentoring resulted in improved research skills, completion of multiple research projects and a number of practice changes. The project’s success was corroborated by an independent evaluation by Capacity Development International¹.

On completion of this 6-country project, the UoM/LAMRN team were fortunate to receive additional funding, through THET, to support evidence-based midwifery practice through audit and feedback in four LAMRN countries. Again, this project was successful, resulting in completion of midwifery-led audits in Kenya, Uganda, Zambia and Zimbabwe and establishment of midwives as leaders of clinical audits in their institutions. The audit findings were presented in a special International Confederation of Midwives edition of the African Journal of Midwifery, which illustrated the clinical and organisational impact of the audits conducted².

Audit has been identified as an effective way of identifying solvable clinical problems that impact on outcomes. However, few midwives in Sub-Saharan Africa have the skills to conduct such audits.

Aim

This project builds on previous experiences by strengthening capacity to conduct clinical audit among midwives in Uganda and Tanzania. The project will develop the leadership skills of LAMRN midwives in Uganda who will offer mentoring to LAMRN midwives in Tanzania. It is envisaged that LAMRN Uganda’s role in this project will ideally position them to sustain a future programme of clinical audits, without requiring UK support.

The project goal is to roll out and sustain effective clinical audit processes in Uganda and Tanzania which will lead to improvements in the quality of maternity care.

The project aim is to strengthen the capacity to conduct clinical audit among midwife practitioners in Uganda and Tanzania

Since Uganda was involved in the previous projects this fund will help strengthen capacities and replicate the experience in another hospital setting. Whereas in Tanzania the focus will be on starting the cycle and build capacities to conduct audit.

Specific objectives

Uganda: to conduct refresher workshop on implementation of clinical audit to:

• help midwives moving into the phase of implementation of clinical audit;
• enhance midwives’s capacities to analyse audit outcomes and complete the cycle (re-audit) in their settings.

Tanzania: to conduct a series of workshops on principle of clinical audit to help midwives to:

• understanding of the audit process;
• develop their abilities to collect and analyse data on auditable problems;
• develop the ability to act on audit findings;
• establish audit as a routine activity in their facilities

Research settings

Uganda:

• Complete audit cycle in Mulago and Jinja
• Start baseline audit in Mukono and Naguru

Tanzania

• Initiate clinical audit in Mara / Geita Regional Hospital and Bugando Medical Centre.