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RN finds unique solutions to global OB obstacles

Nurse-midwife in outreach program provides lasting education for pregnant mothers

Monday February 6, 2012
Angie Fujioka, RN
Angie Fujioka, RN
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The deaths of many mothers and babies from preventable causes has been a stone in the shoe of one nurse for a long time. But Angie Fujioka, ARNP, BSN, MPH, CNM, has worn that stone down a bit by becoming involved in international care of mothers and babies.

As a nurse-midwife, Fujioka serves as a technical adviser for the American College of Nurse-Midwives. Most recently she returned from 11 weeks in Nigeria, where she helped set up a system for training local healthcare workers in essential OB and newborn care.

Unique opportunity
Since initiating her career in international maternal health, Fujioka, now based on the West Coast, has worked in Mexico, the Dominican Republic, Belize, Peru, Guatemala, Zambia and Ethiopia. ACNM's Department of Global Outreach provides technical expertise in preservice education, inservice clinical training in essential obstetric and newborn care, health profession and professional organization development, and strengthening community preparation and response to essential obstetric and newborn care, she said.

Fujioka first experienced international healthcare while satisfying an urge to learn Spanish.

"During my BSN studies, I went to Guatemala for a summer, lived with a local family and volunteered with traditional birth attendants in the western highlands," she explained. "I realized that, in the developing world, pregnancy is a unique opportunity to access healthcare for communities, women and their families."

In addition to onsite training, Fujioka and her colleagues develop and adapt basic curricula.

"For every country we work with, the curriculum needs to be adapted for the local context and the needs of the project," she said. "We have a base curriculum that we're always working with."

Recently, Fujioka wrote revisions and updates to the Nigeria curriculum. For example, ACNM developed "Home Based Life Saving Skills," a community-centered, competency-based, behavior-change program. Its flexible design has 12 preventive and life-saving skills topics appropriate for populations with low literacy rates.

Tailored training programs
Most of ACNM's existing projects are in African countries, Fujioka said. Ongoing programs include strengthening midwifery education in Ghana and maternal health systems in Zambia; offering inservice training in essential obstetric and newborn care for community health workers in Nigeria; and countering maternal and infant mortality by establishing a national Life Saving Skills program in Namibia. Each global project is unique.

Fujioka leaves each setting with a sense of fulfillment.

"During our recent training for midwives in Nigeria, one of the most rewarding experiences was watching the light bulb go on when a midwife resuscitated a baby she would have previously diagnosed as dead, or when she saved a woman's life by treating her postpartum hemorrhage," she said. "It's thrilling to be a part of a process that creates lasting knowledge, skill and attitude shifts.

"Sometimes in the U.S. it's hard to imagine what you can do to reduce maternal and infant mortalities because of the complex and dynamic nature of the contributing factors. I'm grateful to have found a career that attempts to be a part of the solution."

MORE ONLINE: Nurses interested in a similar pursuit can check out the ACNM at www.Midwife.org. For international opportunities, click on professional resources, then global health.

Karen Schmidt, RN, is a freelance writer. Send letters to editorWest@nurse.com or post a comment below.