After working for 10 years in public health and spending many hours training auxiliary health workers, Dr. Glen D. L. Mola decided to enter a residency program for obstetrics and gynecology. It was during this time that he was introduced to Jhpiego and its innovative training techniques. As a participant in two workshops, Dr. Mola learned Jhpiego’s method of transferring competency-based knowledge and skills from expert trainers to health care providers, including using mentor-coaches to ensure that health workers perform clinical skills accurately. In his courses, he learned how to train providers to insert intrauterine contraceptive devices (IUDs) and use laparoscopy in gynecologic procedures.
As a young doctor, Dr. Mola found that Jhpiego’s training “gave me a leg up,” he said during a recent visit to Jhpiego’s offices in Baltimore.
Dr. Mola took his new skills back to Papua New Guinea, where he has used them ever since. Today, he is Professor and Head of Reproductive Health, Obstetrics and Gynecology at the University of Papua New Guinea and based at the Port Moresby General Hospital in the nation’s capital. Dr. Mola, 65, oversees a busy maternity unit where 13,000 women gave birth last year.
In Port Moresby, about 90 percent of women give birth in a health facility. The majority of these births are attended by midwives; physicians are called in during emergencies, Dr. Mola said. That is very different from what occurs in the rest of the country. In Papua New Guinea, only 37 percent of women deliver their babies in health facilities.
The remainder of women—63 percent—give birth at home with just their mother, sister or aunt at their side. The lack of skilled birth care explains, in part, why Papua New Guinea’s current maternal mortality ratio and incidence of postpartum hemorrhage—the leading cause of maternal deaths worldwide—are among the highest in the Western Pacific region.
Transportation is a barrier to women’s receiving proper care. Many villages do not have roads, and pregnant women have to walk to the nearest medical facility, which could be miles away. In addition, many women don’t bother to go to a health facility because they are not confident that they will receive appropriate assistance.
Dr. Mola believes that the hospitals in his country need more nurses and trained midwives and that attitudes around patient care and delivery of service need to be improved. “Whether they come to work or not, rural health workers still receive their pay,” he said. “The systems and management side (of health care) need to be improved,” said Dr. Mola. “Even if we train all the health workers we need, if we are not welcoming to clients (i.e., health providers frown instead of smile) who come seeking maternity care assistance, the unsupervised proportion of births (and therefore the maternity mortality ratio) is not going to improve.”