Tay Samone is a passionate midwife serving at a health center in Nam Bak district, Luang Prabang province. Situated in the north of Lao PDR, this province is famous for its heritage and tourism. It is home to a number of ethnic groups living in remote and mountainous areas. Amongst them the Hmong scattered on the highest latitudes with limited access to health facilities located in suburban low land areas. When we asked Tay Samone about her daily work, she said that her journey was full of various emotions. She feels very relieved when she gets many visits, especially from remote communities, but at the same time, she expresses sadness for the women who do not come at all or those that do come and are not free to make their own choices.

While talking to Tay Samone, she received a visit from a new mother who came for a health check for her newborn but also to receive family planning services postpartum. Tay Samone smiled and said: “I know her; she used to come for pregnancy monitoring. I am so glad that she is back to seek advice on contraception as she wants to space between pregnancies.” Every day Tay Samone and her colleagues receive between ten to 40 patients for ante-natal care and family planning counselling. Having worked at the health centre for three years and has supported so many women, Tay Samone knew that visitors from ethnic minorities were very rare.

When well trained, midwives break the barriers to access family planning

Health workers, counsellors, educators, and midwives play a vital role in changing mentalities and opening a dialogue with local communities. 

“I have been trying to advise one of my patients who is a mother with 14 kids to consider contraceptives. Even though she says she could not make any decisions, I continue to communicate with her,” Tay Samone says, explaining that her patient is afraid that her husband might get a new wife if she refused to give birth. UNFPA and the Ministry of Health have invested considerable effort in building midwives’ capacities by recruiting and training midwives including from different ethnic minority groups.such an initiative is vital for the midwifery programme, because ethnic midwives are already well introduced to their communities. They are trusted and know the realities in the villages. They can exercise easily in their provinces and families won’t prevent women from visiting them.

Training of trainers is run Many times over the year, UNFPA supports the organization of master training workshops. Participants commit after that to transmit their knowledge and train other mates. This initiative is working very well thanks to the mobilization of considerable support from donors. They offer a unique opportunity of learning all the technical skills but also the negotiation, communication, counselling methods to communicate with women, couples, and youth seeking sexual and reproductive health services. 

Joint efforts resulted in the revision of training curricula in order to improve the communication and coordination between schools. South-South cooperation with Thailand, which is technical cooperation among developing countries in the Global South to share knowledge, skills, and successful initiatives was behind the introduction of international training standards. Today, three centres of excellence have been created in midwifery institutions in order to coach and train midwives mentors and teachers. UNFPA continues to support the professional development of Lao Midwives Association. Through all this hard work, Lao PDR had 1716 midwives in 2018. the number of graduated midwives increases by 7.5% each year.

Article will continue to "Building strong Family Planning programmes in Lao PDR: investing in midwives, commodities and behaviour change (2)"

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