Bid to cut childbirth mortality with game for African midwives

MIdwives playing the new gameMIdwives playing the new game

The new game, called Progression, has been designed to help midwives learn to use a partograph – a universally used chart which records a wealth of information on factors such as  heart rate, labour progress, blood pressure and temperature, to flag up any issues with mother and baby.

Midwives generally find the chart difficult to complete. Moreover, they struggle to use it as a decision-making aid. This prevents it being used properly to prevent maternal death and illness due to obstructed and prolonged labour – a major issue in many developing countries.

The game is designed to provide an additional and low cost resource which midwives can use to refresh their knowledge in groups and to spark discussion with each other – ultimately delivering better knowledge of the partograph.

A pilot scheme carried out with 165 midwives in east Africa which has just concluded, reported overwhelmingly that participants found the game useful, entertaining and educational.

Professor Dame Tina Lavender, from the University’s School of Nursing, Midwifery and Social Work, led the project. “The crucial benefit of using this game is that it allows midwives to make mistakes without endangering lives,” she said.  “The game is designed to provide new knowledge, revise what they already know and discuss with other players the best ways to support women. The feedback from midwives working in these countries during the pilot was overwhelmingly positive.”

Progression involves charting a series of findings from a woman in labour.  As players move around the board they land on spaces which trigger a randomly selected card question which they have to answer to keep moving.

It was developed from an idea by Dr Gaynor MacLean with funding from the Laerdal Foundation and the pilot was carried out in partnership with LAMRN – a network of midwives involving The University of Manchester and academics and health workers from Kenya, Malawi, Zambia, Uganda, Zimbabwe and Tanzania. 

The network is dedicated to improving maternal health outcomes in Africa through increasing evidence-based practice in midwifery and the game was one of the outcomes of this collaboration.

The next step is to develop the game for larger scale production and distribution in the LAMRN partner countries.

Professor Lavender added: “This game has been shown in our pilot to enhance midwives’ skills and give them greater confidence in the use of the partograph.  Ultimately this effect will have a significant impact on the outcomes of childbirth for the most vulnerable women and their children in low-income settings.”


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