title: Midwifery capacity building in Papua New Guinea: Key achievements and ways forward.
abstract: BACKGROUND
  Papua New Guinea has some of the poorest health outcomes in the Asia-Pacific region. Maternal mortality is unacceptably high and there is a severe midwifery shortage requiring a quadrupling of the workforce.
  
  
  OBJECTIVE
  This paper outlines the findings of an evaluation of the Maternal Child Health Initiative (MCHI) (2012-2013) to determine key factors contributing to maternal health workforce strengthening.
  
  
  METHODS
  A descriptive mixed methods study was undertaken. Data were gathered through interviews, focus group discussions and surveys with clinicians, midwifery students and staff from nursing and midwifery schools and National Department of Health staff. Documentation from stakeholder meetings and regular site reports were reviewed. Each data set was analysed separately and meta-inferences were drawn across all data.
  
  
  RESULTS
  Learning opportunities were found to have increased for midwifery educators and improvements were described in midwifery educators teaching capacity and student clinical education experience. There was an increase in the number of midwifery graduates and improvements were noted in the working environment and skills of clinical staff. Education challenges were described including the lack of clinical preceptoring and limited continuing education for clinical educators. Participants recommended increasing clinical education hours and extending the length of the midwifery program. Ongoing efforts to accredit the midwifery curricula and regulate midwifery graduates were noted.
  
  
  CONCLUSIONS
  The MCHI has contributed to strengthening the midwifery workforce nationally. However, scaling-up and sustaining these achievements requires leadership and funding commitments from the midwifery schools and government alongside the accreditation of midwifery curricula and regulation of new graduates.
authors.affiliation: Centre for Midwifery Child and Family Health, Faculty of Health, University of Technology, Sydney, PO Box 123, Ultimo, NSW 2007, Australia. Electronic address: angela.dawson@uts.edu.au.
authors.forename: Angela
authors.initials: A
authors.lastname: Dawson
authors.affiliation: Papua New Guinea National Department of Health, AOPI Centre, Waigani Drive, PO Box 807, Waigani 131, Port Moresby, National Capital District, Papua New Guinea.
authors.forename: Mary
authors.initials: M
authors.lastname: Kililo
authors.affiliation: Papua New Guinea National Department of Health, AOPI Centre, Waigani Drive, PO Box 807, Waigani 131, Port Moresby, National Capital District, Papua New Guinea.
authors.forename: Lahui
authors.initials: L
authors.lastname: Geita
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine and Health Sciences, University of Papua New Guinea, PO Box 320, University 134, Port Moresby, National Capital District, Papua New Guinea.
authors.forename: Glen
authors.initials: G
authors.lastname: Mola
authors.affiliation: Centre for Midwifery Child and Family Health, Faculty of Health, University of Technology, Sydney, PO Box 123, Ultimo, NSW 2007, Australia.
authors.forename: Pat M
authors.initials: PM
authors.lastname: Brodie
authors.affiliation: World Health Organization Collaborating Centre for Nursing, Midwifery and Health Development, Faculty of Health, University of Technology, Sydney, PO Box 123, Ultimo, NSW 2007, Australia.
authors.forename: Michele
authors.initials: M
authors.lastname: Rumsey
authors.affiliation: Centre for Midwifery Child and Family Health, Faculty of Health, University of Technology, Sydney, PO Box 123, Ultimo, NSW 2007, Australia.
authors.forename: Felicity
authors.initials: F
authors.lastname: Copeland
authors.affiliation: World Health Organization Collaborating Centre for Nursing, Midwifery and Health Development, Faculty of Health, University of Technology, Sydney, PO Box 123, Ultimo, NSW 2007, Australia.
authors.forename: Amanda
authors.initials: A
authors.lastname: Neill
authors.affiliation: Centre for Midwifery Child and Family Health, Faculty of Health, University of Technology, Sydney, PO Box 123, Ultimo, NSW 2007, Australia.
authors.forename: Caroline S E
authors.initials: CS
authors.lastname: Homer
mesh_terms: D000124:Achievement; D057191:Capacity Building; D003479:Curriculum / Q000592:standards*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008880:Midwifery / Q000193:education*; D010219:Papua New Guinea; D011247:Pregnancy; D036301:Qualitative Research; D013192:Staff Development / Q000379:methods*; D000078329:Workforce
keywords: Capacity building; Maternal health; Midwifery; Midwifery workforce; Papua New Guinea