Opportunities and Challenges of Advanced Practice Midwifery (APM) in Kenya: A Discussion Paper

Abstract

Background: The high maternal and neonatal deaths remain a global concern especially in Low- and Middle-Income Countries. This is largely attributed to the limited skilled workforce including midwives who are required to offer quality maternal and neonatal care. Advanced Practice Midwifery (APM) training has been highlighted as critical in achieving high-quality maternal and neonatal care in all settings and countries. In Kenya, the APM training is at the initial stages, having been launched in May 2022. This paper presents the results of a literature review regarding opportunities and challenges for the APM training and practice with a goal of availing information to any institution willing to begin the program in Kenya and other LMICs. Methodology: A descriptive overview was undertaken through a rapid literature review of the relevant local and international literature to highlight the opportunities and challenges for the APM training and practice based on the Kenyan Context. Results: The APM training and practice has expansive opportunities such as the increased demand for quality care and reduced cost services, supportive policies, advances in technology, profession recognition and regularisation of the training and availability of midwives trained at lower levels. The challenges that the APM training is likely to experience includes; Lack of expert trainers, technological challenges, workload challenges due to the high population in need of the services and clinical environment challenges. Conclusion: APM training and practice has enormous opportunities despite the challenges that may be experienced. Therefore, for any institution preparing to start the APM training, there is need to exploit the existing opportunities and address the likely challenges to ensure the APM training and practice meets the desired outcomes.