Saurabh R Shrivastava1, Prateek S Shrivastava2, Jegadeesh Ramasamy2. 1. Department of Community Medicine, Member of the Medical Education Unit and Medical Research Unit, Ammapettai, Chennai, Tamil Nadu, India. 2. Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India.
Dear Editor,The available global estimates indicate that each day more than 825 women die owing to preventable causes associated with pregnancy and childbirth.[1] In fact, owing to the lack of coordinated efforts and shortcomings of the health sector, most nations failed to accomplish the targets proposed under the Millennium Development Goals (MDG).[1]The analysis of maternal deaths in Cambodia revealed that significant progress has been achieved in decreasing pregnancy-associated deaths, with the nation being successful in achieving the MDG target.[2] Nevertheless, even today more than 160 women die for every 0.1 million live births, and the estimates are quite high when compared with the regional estimates.[2]To bring down maternal deaths in Cambodia, large numbers of midwives have been trained for a period of one month to enhance their skills in emergency obstetric and newborn care.[2] Both training programs are organized by the United Nations Population Fund (UNFPA), comprising not only practical exposures under strict supervision but even role play exercises and management of the complications that can occur during delivery to make them well-equipped to deal with different challenges.[2] This training is an indispensable requirement as without adequate acquisition of skills midwives can endanger the lives of both the women as well as the newborn child.[2]It is important to understand that these training sessions help midwives to acquire skills in real world circumstances under close supervision.[3] To make these sessions more useful, the emphasis is more towards the frequently observed complications, and midwives are being trained in managing the same effectively.[2] At the same time, as most of the women are quite nervous about giving birth, these midwives offer a supportive environment to them during labor as well as explain to them the do's and don'ts in different situations.[2]The available estimates suggest that, since the start of the current decade, more than 1000 midwives have been trained in Cambodia to provide quality assured emergency obstetric and newborn care by the UNFPA.[2] Moreover, efforts have been taken to expand emergency care facilities across the nation to prevent the occurrence of any life-threatening complications.[2]To conclude, the initiative of UNFPA to train midwives in Cambodia is a landmark initiative to improve the quality of emergency obstetric and newborn care services, especially because of the acute shortage of trained doctors in the rural settings. Further, based on the encouraging results from Cambodia, the World Health Organization and other international welfare agencies should support other developing nations to conduct training program for the working midwives.