South-to-South Technical Assistance Strengthening Midwifery Education Peru to Paraguay

In 2010, IAB updated its midwifery curriculum by incorporating a competency-based approach as part of an institutional effort to strengthen education programs and seek national accreditation. IAB directors requested support from USAID Washington to implement the new curriculum. The Faculty of Midwifery and Nursing (FOE) of Universidad de San Martin de Porres (USMP) in Lima, Peru, collaborated with IAB through the Maternal and Child Health Integrated Program (MCHIP) to provide South-to-South technical assistance among midwifery schools. FOE USMP had attained international accreditation and had extensive experience leading the successful implementation of an updated curriculum in Peru since 2006. During field visits to Paraguay, FOE USMP professors noted that Paraguayan midwives lacked a clear definition of their professional role in society or within healthcare teams. There were no national regulations to guide the structure and quality of training professional midwives. As a result, midwifery training schools in Paraguay implemented customized curricula that did not necessarily meet standardized education principles or the needs of the country. The project aimed to strengthen midwifery education in Paraguay by providing technical assistance from Peru. A team of FOE USMP instructors analyzed and revised IAB's curriculum to deliver training in five years, incorporating the definition of the professional midwife profile and global competencies recommended by the International Confederation of Midwives. The updated curriculum was developed based on the competency-based approach, which emphasizes the importance of a comprehensive, holistic education to ensure timely and competent professional conduct and the humanization of midwifery care. The focus was on improving the quality of midwifery education and developing a cadre of professional midwives with a distinct identity and set of competencies representing the full scope of midwifery practice. The project involved six midwifery schools in Paraguay, including IAB, which was the only midwifery school offering free-tuition education in Paraguay and receiving full recognition and prestige from its peers. The schools created the Paraguayan Association of Midwifery Professional Schools (ACUFOPY), which is taking the lead in managing the activities of the six participating schools and is currently filing for legal status. The process of updating the midwifery curriculum included the delivery of trainings for school directors, classroom faculty, and clinical preceptors, with an emphasis on reinforcing their knowledge and competency-based skills. The trainings were delivered online, followed by workshops in Paraguay, and field visits and exchange meetings in Peru. All activities engaged representatives from the National Association of Midwives and from the Midwifery Unit of the Ministry of Health in Paraguay. The project faced several challenges, including the limited identification of midwifery faculties as professional midwives, low valuation of the role of midwives, and poor coordination between classroom faculty and clinical preceptors. However, the project achieved several milestones, including the development of a core competency-based curriculum, training of teams of directors and midwifery faculty, and the creation of ACUFOPY. The project also led to improved coordination among midwifery schools through the national Midwifery Association and the Ministry of Health. The National Agency of Higher Education Assessment and Accreditation adopted the core competences included in the new curriculum as standards for the process of accrediting midwifery programs. A legal framework to protect the labor rights of midwives is currently in the approval process in the national parliament.