The Unpleasant Way Forward For The Community Health Nurse

It became a relieved news when our hardworking females Community Health Nursess ( CHNs ) initially had the opportunity to further their professional careers as Community Midwives, before the males were also allowed to enroll.

We have also recently had the chance to upgrade our current certificate to Diploma in community health nursing. This sounds relieving because after all it has given a little hope and an opportunity for most of us to get to where we realy would like to be some day in our careers.

..But at what expense are they (MOH,GHS and NMC) offering such hypocritical opportunities?

The path of education follows an acsending order from Primary through Secondary to Post secondary.

Career Progression is the process of developing into an advance state in the job you do during your working life.

Each level serves as the base for the next level so; Why should it be a different case when it comes to the health sector?

Lets take a look at the Post basic midwifery…
Ghana is working towards the achievement of Millennium Development Goal 5 (improving maternal health). Meaning by 2015 the maternal death rate should reduce to 185/100000 live birth and thus logic to recruit more profesional Midwives to reduce the midwife to patients ratio which stood at an amazing figure of 1:7200 (2010). As at 2013 Ghana had about 4,035 midwives, approximately 1 midwife to 6,155 patient ratio which is still yet to meet WHO’s recommendation of 1 midwife to a 1,000 patients. This reason is good enough to recruit more midwives but my question is; DOES THIS SATISFY THE COMMUNITY HEALTH NURSES (CHNs). It is no suprise to hear a big NO answer.

My main focal point will be on the Community midwifery programe

Everyone wants to progress in whatever they pursue in this life so does the CHN with the certificate who has been an integral part towards achieving MDG4 and 5.

Why will the CHN be awarded with just a salary increment and a new professional name (community midwife) with the same certificate after pursuing a two year post basic midwifery program?

,,,Why the refusal to award them with a diploma certificate having alredy studied for two years and practiced for more than 3years and studied two years further to obtain the same grade…Is that what we call a Career Progresion?

..Why will they be called Community Midwives and basically trained to be posted to the rural communities?

Am not against the postings and the name but the discriminatory manner in which these category of nurses are handled.

So on what merit are they admitted to study the midwifery program? Is it because the health sector wants to fill the gap in the number of midwives require in the country or they (GHS, MOH, Nurses and Midwifery Council) wanted to give them a Career progresion in disguise?

For proper understanding, lets consider the differences between the current midwives excluding those with degrees.

The registered midwives starts their education fresh from SHS and enroll the programe for three years and they are awarded a Diploma certificate. On the other hand the community midwife first has to pass out as either a Community health nurse or a Health Assistant after being enrolled for tow years in their respective institutions. They are then posted to the field to work for a three year minimum period before being allow to apply for the community midwifery with their certificates and again awarded a the same certficate.

…You may want to ague about the period difference…YES! The registered midwife studies for 3 years while the Community midwife studies for 2… But another question is……

..What happens to the two years initial training in School and over 3 years of working experience?

Incase you want know, these years spent in school were not just used in practicing only Injections and health talks. The basics for the 3 year training which includes Anatomy and Physiology, Obstetrics, Child health and others were all studied by the community health nurse.. In addition to these courses one has to practice for at least a three year minimum before you can be considered for admision to read to become a Community midwife for which you will not be awarded with a diploma.. So if indeed MOH knows that the CHNs have enough knowledge to study the programe for two years; then why can’t they be awarded with certificate they deserve after completion.

Also why should they be branded as community midwives.

It has become very clear that the problems facing the community health nurses is no of concern to GHS. Yet more CHPS compounds are being built across most rural areas all over the country to complement the primary health care system of which the core role players are the Community health nurses.

In mine opinion if this should be the way forward, for the CHNs then am afraid the Health sector has a huge mountain to climb to improve their definition as far as career progression is concern.


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