Human Resources for Health in Maternal, Neonatal and - HRH ...

Accreditation and certification
The accreditation of education training institutions and programmes involves processes
designed to assess whether minimum standards have been achieved in MNRH. These
standards are usually established by relevant regulatory authority in countries and can cover
clinical and promotive aspects of health care. Health workers who graduate from accredited
programmes can then become certified for practice and registered with the relevant
professional body. The Kampala Declaration calls for the development of rigorous
accreditation systems for health worker education and training (Global health workforce
alliance 2008) which includes pre service as well as in service training. This is a challenge at
community level as not all cadres are represented by professional bodies and training for
cadres such as TBAs and those categorized under the community health worker group can be
ad hoc and run by a number of providers. As a result practitioners at community level may be
poorly prepared for practice, receive no or irregular in-service training and work unlicensed
and unregulated. This has implications for the quality of service provision across
communities.
A number of organisations have undertaken work in the area of midwifery education
accreditation. In Afghanistan Jhpeigo have worked with the Ministry of Public Health to
develop 59 educational standards which will be used by the Midwifery Education
Accreditation Board (Jhpeigo 2005). The Board oversees the process of external evaluation
and formal accreditation of midwifery schools. The accreditation process employs both
internal and external reviews using specific assessment tools that detail four areas of the
national educational standards. The areas of focus include classroom and practical
instruction, clinical instruction and practice, school infrastructure and materials, and school
management. Midwifery schools also use the explicitly detailed standards to evaluate their
own performance, define their needs and monitor their progress.
WHO has recently developed global standards for initial nursing and midwifery
education(WHO 2008). These identify the essential, critical components of education and
provide a guide for countries who may be revising or developing their own standards. A
WHO and UNFPA South East Asian regional meeting on the accreditation of communitybased
skilled birth attendants provided a key forum for discussion on ways forward in the
region(WHO/UNFPA 2005). The workshop enabled participants to analyze and share
information on the challenges facing countries working on accreditation of skilled birth
attendants at primary health care level and to consider the regional acceptability of WHO
ICM guidelines on regulation and licensing of midwifery practitioners based on country
experiences engaged in similar work. In addition the participants identified a number of gaps
in the SEARO Standards of Midwifery Practice for Safe Motherhood for use in accrediting
community-based skilled birth attendants. A common framework was finalised for
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