Speaker: Melese Siyoum
Facilitator: Indri Astuti Purwanti
Back ground: Pelvic organ prolapse (POP) is a common condition that can significantly impact a woman’s quality of life. Pelvic floor muscle training (PFMT) is recommended as a first-line conservative treatment for prolapse, but evidence from low-resource settings is limited.
Objectives: This study aimed to assess midwife-led pelvic floor muscle training on prolapse symptoms and health-related quality of life (HRQoL) among women with mild to moderate prolapse in Ethiopia, 2024.
Methods: A community-based, parallel, two-arm cluster randomized controlled trial was conducted in Dale and Wonsho districts of Sidama Region, Ethiopia. Women with symptomatic POP stage I-III were randomized by cluster to receive either midwife-led PFMT plus lifestyle counseling (intervention group) or lifestyle counseling alone (control group). The primary outcomes were change in prolapse symptom score (POP-SS) and prolapse quality of life (P-QoL). Mixed-effects generalized linear model was used to determine the effect size at 99% confidence level.
Results: A total of 187 women were randomized (intervention = 89 and control = 98). At sixth month, the intervention group showed significantly greater improvements with a mean change difference of: -4.1 (99% CI: -5.38, -2.83) in prolapse symptoms; -11.48 (99% CI: -15.9, -7.1) in physical domain, -12.65 (99% CI: -19.3, -6.1) in psychological domain and -9.47 (99% CI: -15.5, -3.5) in personal relationship domain of P-QoL. A significantly higher number of women in the intervention group perceived their condition as ‘better’ after the intervention. Women with earlier stages of prolapse (stage I and II) experienced higher benefits compared to stage III.
Conclusions: A midwife-led PFMT combined with lifestyle counseling significantly improves prolapse symptoms and quality of life in mild to moderate POP. This strategy can be integrated into the existing maternal and reproductive health programs to address POP in low-income settings where access to trained specialist is limited.
Speakers: Erin Gilmer and Zahra Mirzaei
Facilitator: Isabella Garti
Background: In December 2024, the Taliban banned women from attending midwifery and nursing institutes in Afghanistan, cutting off the last remaining avenue for women’s higher education. This policy threatens maternal and newborn health in a country where the maternal mortality ratio at 620 deaths per 100,000 live births, one of the highest in the world. Afghan midwives are essential frontline providers, particularly in rural areas; therefore, sustaining midwifery education is vital to ensuring continued healthcare access for Afghan women and families.
Purpose: In response to this crisis, Kabul Online Medical University in Exile (KOMU-E) has launched an innovative online midwifery education program. This initiative aims to preserve academic continuity for Afghan midwifery students, sustain their engagement with the midwifery profession, and provide a critical lifeline for education and wellbeing.
Focus of Presentation: This presentation explores the implementation of KOMU-Es online midwifery education initiative. Grounded in the Afghan midwifery curriculum and aligned with ICM Essential Competencies, the program is delivered by experienced Afghan midwives in the diaspora. Currently, the program focuses on theory-based coursework while KOMU-E explores strategies for safe and effective hands-on learning and clinical experience. Importantly, the program integrates psychosocial support to address the mental health impact of educational exclusion.
The session will highlight the challenges, strategies, and impact of delivering midwifery education in a highly restrictive environment. We also hope to connect with audience members with experience in blended learning models for midwifery education.
