Empower nurses, says UNFPA

Empower nurses, says UNFPA

MOKHOTLONG – THE United Nations Populations Fund (UNFPA) says empowering nurses to make key decisions could significantly cut infant and maternal mortality in Lesotho.
The UNFPA says there is so much that nurses and midwives are restricted from doing within the health practice.
The statistics of infant mortality and maternal mortality could be lowered if such restrictions are removed.

Dr Marc Derveeuw, the UNFPA’s country director, said this while visiting ’Malefiloane Health Centre, a two-hour on gravel roads from Mokhotlong town.
“The public health system in Lesotho is intensely driven by nurses but they have little authority or power in the system they manage in great numbers,” Dr Derveeuw said.

The nurse-midwifery population in Lesotho is at almost 5 000 according Dr Semakaleng Phafoli, a senior technical adviser for Jhpiego in an article published in thepost.
Dr Phafoli stated that nurses lead in over 80 percent of health centres in the country.
“As a result, nurse-midwives single-handedly manage Lesotho’s primary healthcare clinics, particularly in rural areas, where about three-quarters of Basotho people live,” Dr Phafoli said.
Dr Derveeuw said Lesotho’s high maternal mortality rates are worrying.
“The statistics are still very high even with the best equipped primary health facilities and I simply want to understand why women still die in such good facilities,” he said.

According to the Lesotho Health Sector Strategic Plan 2012/2013-2016/2017, the main causes of maternal deaths in Lesotho are postpartum sepsis, complication of abortion, obstructed or prolonged labour, pre and eclampsia and haemorrhage.

It said unless significant investments are made in primary health care the numbers are not likely to drop significantly.
Dr Derveeuw said there are measures that nurses can take to improve the situation, especially because many patients travel long distances.

Patients at ’Malefiloane Health Centre said they travelled almost two hours to get to Mokhotlong Hospital on a bumpy, meandering gravel road.
“Imagine a prolonged labour patient travelling on this kind of road for hours to get help to a hospital when a simple no-complicated producer can be used by a nurse to save that life,” Dr Derveeuw said.
Dr Phafoli said nurses should advocate for changes in the law if they want more authority.
“Nursing in my country is guided by the Lesotho Nursing Act of 1998. Its no longer addresses the current scope of nursing and midwifery practice,” Dr Phafoli said.
“The 1998 Nursing Act was revised in 2016 and became the Lesotho Nursing and Midwifery Act of 2016, which gives nurses more authority. But it hasn’t yet been in enacted by Parliament,” she said.
“But we also need to change how we learn to nurse.”

One in every 32 women dies due to pregnancy and childbirth-related conditions and such deaths can be avoided, according the Lesotho Health Sector Strategic Plan.
Dr Derveeuw said when nurses are adequately empowered with technical skills that do not require extensive lab training they can concentrate more on saving lives and shift other services to village health workers (VHW).

Such services that can be delivered by VHW, according to Dr Derveeuw, include dispensation of family planning pills to ease congestion at the health facility.
“Village health workers are already doing so much in the health system of the country,” he said.
“They are the biggest arms of health in Lesotho and we need to broaden their scope of work.”

Rose Moremoholo


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