At Club Courage, midwives meet monthly to share, discuss and reflect on their professional and personal lives. Prompted by a set of discussion cards, they explore care for self, care for clients, care for family and care for colleagues.
“Midwives face stress, trauma and life-threatening situations in their work. We face issues such as inadequate work equipment, dilapidated infrastructure, stockouts, severe staff shortages and inefficient referral systems,” says a midwife, with 10 years of experience, who participated in the Jhpiego-led intervention at a referral health facility in Mali last year.*
The monthly club format was designed to provide nurses and midwives with opportunities to discuss ways to address stress that impacts their service. Improving the well-being of midwives through peer support holds the potential to improve health outcomes and advance gender equality.
“We believe that for clients, especially pregnant women to have quality care and positive pregnancy experience, we need to address the stress and trauma that providers face. This is also reflected in global evidence on health care providers’ experience and service provision,” says Assiata Ba, a manager of education and training in Jhpiego’s Mali office who participated in the initial research on Club Courage.
Jhpiego experts and Think Place developed the Club Courage model in 2020 with support from the Bill & Melinda Gates Foundation through the Antenatal/Postnatal Care Research Collective.
They piloted the club approach in Mali and later introduced it in Ghana.
During meetings, a support group of eight to 12 midwives use cards to prompt discussions that build peer support and resilience. Each card includes a question about a topic along with evidence-based advice for support followed by affirmations, such as “I will treat all clients, regardless of their age or background, the same way I would like to be treated if I gave birth at this facility.”
In Mali last year, through Jhpiego’s Catalyst Innovation Fund, 120 midwives from seven community referral health centers participated in Club Courage meetings. And the response was positive.
“The Club Courage meetings have improved interpersonal communication and the relationship between us and our colleagues. Most importantly, it has allowed us to understand and address our emotions and factors affecting mental well-being,” says one midwife participant. “The overall results are open and better interaction with clients.
“Through these sessions, we hope to encourage being open to sharing stressful experiences. This has increased peer support, and improved self-care practices among midwives,” she adds. “If midwives feel supported, they will be better at providing respectful and empathetic quality care to the patients.”
*The names of midwives have been withheld due to privacy and research protocols.