COMMUNITY MIDWIFERY
Course objective
By the end of the course, the student will be able to;
a. Describe factors that influence population growth
b. Discuss maternal and infant morbidity and mortality
c. Explain the Private Hospital and maternity Homes Act and Nursing and Midwifery
Council rules concerning midwifery practice
d. Discuss domiciliary midwifery
e. Describe the role of the Community Health Officer/midwife
f. Describe the role of traditional birth attendant
Course content
1. Factors that influence population growth
a. Fertility
b. Morbidity
c. Migration
2. Midwife `s responsibilities regarding vital statistics
a. Fertility rate
b. Mortality rates
c. Morbidity rates
d. Still birth rate
3. Causes and prevention of maternal and infant morbidity
1. District midwifery practice
a. Private Hospitals and Maternity Homes Act
b. Nursing and Midwifery Council rules concerning midwifery practice
c. Domiciliary midwifery
i. Preparation for home delivery
ii. Selection of clients
iii. Home visits
iv. Examination of mother and baby(review)
v. Notification and registration of birth
vi. Post natal visit (review)
vii. Immunization and cold chain (review)
2. The role of the CHO in maternal and neonatal health (review)
3. Traditional birth attendant (TBA);Role in the community
4. Safe mother hood; Emergency obstetric care
1
,FACTORS THAT INFLUENCE POPULATION GROWTH
1. Decline in the Death Rate: (MORTALITY) at the root of overpopulation is the difference
between the overall birth rate and death rate in populations. If the number of children born
each year equals the number of adults that die, then the population will stabilize. Talking
about overpopulation shows that while there are many factors that can increase the death rate
for short periods of time, the ones that increase the birth rate do so over a long period of time.
The discovery of agriculture by our ancestors was one factor that provided them with the
ability to sustain their nutrition without hunting. This created the first imbalance between the
two rates.
2. Better Medical Facilities: Following this came the industrial revolution. Technological
advancement was perhaps the biggest reason why the balance has been permanently
disturbed. Science was able to produce better means of producing food, which allowed
families to feed more mouths. Medical science made many discoveries thanks to which they
were able to defeat a whole range of diseases. Illnesses that had claimed thousands of lives
till now were cured because of the invention of vaccines. Combining the increase in food
supply with fewer means of mortality tipped the balance and became the starting point of
overpopulation.
3. More Hands to Overcome Poverty: However, when talking about overpopulation we
should understand that there is a psychological component as well. For thousands of years, a
very small part of the population had enough money to live in comfort. The rest faced
poverty and would give birth to large families to make up for the high infant mortality rate.
Families that have been through poverty, natural disasters or are simply in need of more
hands to work are a major factor for overpopulation. As compared to earlier times, most of
these extra children survive and consume resources that are not sufficient in nature.
4. Technological Advancement in Fertility Treatment: With latest technological advancement
and more discoveries in medical science, it has become possible for couple who are unable to
conceive to undergo fertility treatment methods and have their own babies. Today there are
effective medicines which can increases the chance of conception and lead to rise in birth
rate. Moreover, due to modern techniques pregnancies today are far safer.
5. Immigration: Many people prefer to move to developed countries like US, UK, Canada and
Australia where best facilities are available in terms of medical, education, security and
employment. The end result is that those people settle over there and those places become
overcrowded. Difference between the number of people who are leaving the country and the
number of people who enter narrows down which leads to more demand for food, clothes,
energy and homes. This gives rise to shortage of resources. Though the overall population
remains the same, it just affects the density of population making that place simply
overcrowded.
It is as a result of a ‘pull factor’ which attracts them such as for greener pasture. It
increases the population. Others such as culture, agricultural and economic development
2
, have effect on population growth by affecting the three main factors that influence
population growth.
6. Lack of Family Planning: Most developing nations have large number of people who are
illiterate, live below the poverty line and have little or no knowledge about family planning.
Getting their children married at an early age increase the chances of producing more kids.
Those people are unable to understand the harmful effects of overpopulation and lack of
ignorance prompts them to avoid family planning measures.
MIGRATION This is the movement of people from one place to another with the intension of
settling in the new place or location. It can be emigration or immigration which may be intra-
national or international.
Emigration is the act of leaving one’s own country (town) to settle permanently in another town
within the same country. It is as a result of a ‘push factors’ which repels them such as war,
famine, lack of resources, natural disasters e.g. Earth quakes, hurricane. It decreases the
population.
People who are forced to leave their country to another due to war etc are called refugees.
Immigration is the movement of people into a country to which they are not native or citizen in
other to settle there, especially as permanent residents or future citizens.
REASONS WHY PEOPLE MIGRATE
Education
Famine
Job / Employment
Social amenities
During war
To escape natural disasters such as famine, earthquake etc.
Marriage
NEGETIVE EFFECT OF MIGRATION
People usually migrate in search for jobs or greener pastures and when they are not able to
achieve that they end up in social vices such as;
Stealing / pick pocketing
Arm robbery
3
, Unsafe sex increasing their risk of STI’s, unwanted pregnancies
Drug addiction
Prostitution.
Low productivity in the urban areas
High pressure on social amenities
MIDWIFE `S RESPONSIBILITIES REGARDING VITAL STATISTICS
Is the study of collection, organization, analysis, and presentation of data. It deals with all aspect
of data including planning of data collection and analysis data using statistical methodology.
The role of the midwife, who is the person present virtually at every birth is key witness to and is
responsible to;
1. Supply details of births and deaths occurring within your practice
2. Be able to calculate the various mortality statistics that are of interest to midwives
3. Reporting for statistics i.e. vital statistics on maternal and neonatal health
4. Apply statistical methodology in collection, organization and analysis of data for health
research
5. Interprets and explain the various mortality statistics that are calculated.
6. Define maternal and infant vital statistics
7. Quantify a quality of care based on maternal and infant statistics
8. Decision making on maternal and infant statistical findings
9. Predicting outcomes based on reliable findings
10. Communicating and dissemination to all information’s (data), results and findings
DEMOGRAPHY
It is the statistical study of the characteristics to human population especially with
reference to the size, and density, growth and the effect of all these on social and
economic condition
FERTILITY RATE
Is the number of birth per 1000 women in the reproductive age (14-49) in a given year /per
year? Total fertility rate represents the number of children that would be born to a woman if she
were to live to the end of her child bearing years and bear children in accordance with current
age- specific fertility rates.
Both birth rate and fertility rate are closely related but different. It is high in the under develop
countries and low in the developed countries. It increases the population size.
MORTALITY RATE
4
Course objective
By the end of the course, the student will be able to;
a. Describe factors that influence population growth
b. Discuss maternal and infant morbidity and mortality
c. Explain the Private Hospital and maternity Homes Act and Nursing and Midwifery
Council rules concerning midwifery practice
d. Discuss domiciliary midwifery
e. Describe the role of the Community Health Officer/midwife
f. Describe the role of traditional birth attendant
Course content
1. Factors that influence population growth
a. Fertility
b. Morbidity
c. Migration
2. Midwife `s responsibilities regarding vital statistics
a. Fertility rate
b. Mortality rates
c. Morbidity rates
d. Still birth rate
3. Causes and prevention of maternal and infant morbidity
1. District midwifery practice
a. Private Hospitals and Maternity Homes Act
b. Nursing and Midwifery Council rules concerning midwifery practice
c. Domiciliary midwifery
i. Preparation for home delivery
ii. Selection of clients
iii. Home visits
iv. Examination of mother and baby(review)
v. Notification and registration of birth
vi. Post natal visit (review)
vii. Immunization and cold chain (review)
2. The role of the CHO in maternal and neonatal health (review)
3. Traditional birth attendant (TBA);Role in the community
4. Safe mother hood; Emergency obstetric care
1
,FACTORS THAT INFLUENCE POPULATION GROWTH
1. Decline in the Death Rate: (MORTALITY) at the root of overpopulation is the difference
between the overall birth rate and death rate in populations. If the number of children born
each year equals the number of adults that die, then the population will stabilize. Talking
about overpopulation shows that while there are many factors that can increase the death rate
for short periods of time, the ones that increase the birth rate do so over a long period of time.
The discovery of agriculture by our ancestors was one factor that provided them with the
ability to sustain their nutrition without hunting. This created the first imbalance between the
two rates.
2. Better Medical Facilities: Following this came the industrial revolution. Technological
advancement was perhaps the biggest reason why the balance has been permanently
disturbed. Science was able to produce better means of producing food, which allowed
families to feed more mouths. Medical science made many discoveries thanks to which they
were able to defeat a whole range of diseases. Illnesses that had claimed thousands of lives
till now were cured because of the invention of vaccines. Combining the increase in food
supply with fewer means of mortality tipped the balance and became the starting point of
overpopulation.
3. More Hands to Overcome Poverty: However, when talking about overpopulation we
should understand that there is a psychological component as well. For thousands of years, a
very small part of the population had enough money to live in comfort. The rest faced
poverty and would give birth to large families to make up for the high infant mortality rate.
Families that have been through poverty, natural disasters or are simply in need of more
hands to work are a major factor for overpopulation. As compared to earlier times, most of
these extra children survive and consume resources that are not sufficient in nature.
4. Technological Advancement in Fertility Treatment: With latest technological advancement
and more discoveries in medical science, it has become possible for couple who are unable to
conceive to undergo fertility treatment methods and have their own babies. Today there are
effective medicines which can increases the chance of conception and lead to rise in birth
rate. Moreover, due to modern techniques pregnancies today are far safer.
5. Immigration: Many people prefer to move to developed countries like US, UK, Canada and
Australia where best facilities are available in terms of medical, education, security and
employment. The end result is that those people settle over there and those places become
overcrowded. Difference between the number of people who are leaving the country and the
number of people who enter narrows down which leads to more demand for food, clothes,
energy and homes. This gives rise to shortage of resources. Though the overall population
remains the same, it just affects the density of population making that place simply
overcrowded.
It is as a result of a ‘pull factor’ which attracts them such as for greener pasture. It
increases the population. Others such as culture, agricultural and economic development
2
, have effect on population growth by affecting the three main factors that influence
population growth.
6. Lack of Family Planning: Most developing nations have large number of people who are
illiterate, live below the poverty line and have little or no knowledge about family planning.
Getting their children married at an early age increase the chances of producing more kids.
Those people are unable to understand the harmful effects of overpopulation and lack of
ignorance prompts them to avoid family planning measures.
MIGRATION This is the movement of people from one place to another with the intension of
settling in the new place or location. It can be emigration or immigration which may be intra-
national or international.
Emigration is the act of leaving one’s own country (town) to settle permanently in another town
within the same country. It is as a result of a ‘push factors’ which repels them such as war,
famine, lack of resources, natural disasters e.g. Earth quakes, hurricane. It decreases the
population.
People who are forced to leave their country to another due to war etc are called refugees.
Immigration is the movement of people into a country to which they are not native or citizen in
other to settle there, especially as permanent residents or future citizens.
REASONS WHY PEOPLE MIGRATE
Education
Famine
Job / Employment
Social amenities
During war
To escape natural disasters such as famine, earthquake etc.
Marriage
NEGETIVE EFFECT OF MIGRATION
People usually migrate in search for jobs or greener pastures and when they are not able to
achieve that they end up in social vices such as;
Stealing / pick pocketing
Arm robbery
3
, Unsafe sex increasing their risk of STI’s, unwanted pregnancies
Drug addiction
Prostitution.
Low productivity in the urban areas
High pressure on social amenities
MIDWIFE `S RESPONSIBILITIES REGARDING VITAL STATISTICS
Is the study of collection, organization, analysis, and presentation of data. It deals with all aspect
of data including planning of data collection and analysis data using statistical methodology.
The role of the midwife, who is the person present virtually at every birth is key witness to and is
responsible to;
1. Supply details of births and deaths occurring within your practice
2. Be able to calculate the various mortality statistics that are of interest to midwives
3. Reporting for statistics i.e. vital statistics on maternal and neonatal health
4. Apply statistical methodology in collection, organization and analysis of data for health
research
5. Interprets and explain the various mortality statistics that are calculated.
6. Define maternal and infant vital statistics
7. Quantify a quality of care based on maternal and infant statistics
8. Decision making on maternal and infant statistical findings
9. Predicting outcomes based on reliable findings
10. Communicating and dissemination to all information’s (data), results and findings
DEMOGRAPHY
It is the statistical study of the characteristics to human population especially with
reference to the size, and density, growth and the effect of all these on social and
economic condition
FERTILITY RATE
Is the number of birth per 1000 women in the reproductive age (14-49) in a given year /per
year? Total fertility rate represents the number of children that would be born to a woman if she
were to live to the end of her child bearing years and bear children in accordance with current
age- specific fertility rates.
Both birth rate and fertility rate are closely related but different. It is high in the under develop
countries and low in the developed countries. It increases the population size.
MORTALITY RATE
4
