Ultrasound working group W. Motlolometsi K. Makhathini R. Motete

Scope of practice – Basic Midwife R2598 Chapter 3 - Acts and procedures Diagnosing of a health need and the facilitation of the attainment of optimum physical and mental health for the mother and child The monitoring of the progress of pregnancy , labour and puerperium Monitor the reaction of the mother and child to disease conditions, trauma, stress, anxiety, medication and treatment

Competencies of a midwife Specialist by SANC Assesses and screens streams of health care users of Reproductive Health Services – during ANC ….. Detects high risk factors and/ or complications of pregnancy…. Diagnoses problems… Diagnose high risk factors Ensure implementation of appropriate packages of care to ensure good outcomes in MNCWH (BANC….) Appropriate referral if needed

ICM competency 3 Knowledge and understanding of ….. principles of dating pregnancy by menstrual history, size of uterus, fundal growth patterns and use of ultrasound (if available) implications of deviation from expected fundal growth patterns, including intrauterine growth retardation/restriction, oligo- and polyhydramnios, multiple foetuses how to determine foetal well-being during pregnancy including foetal heart rate and activity patterns

Questions Do we need Midwives trained on Ultrasound ?If so why give reasons Who should be targeted for training and why Which training model should be taken what specific issues should be included in ultrasound ( basic ultrasound v/s diagnostic 4. Accreditation how should the process be taken forward Protection against litigation 5. How should the training be rolled out Centralized Decentralized Pilot

Task shifting Implication of Ultrasound in relation to task shifting Cannot be considered as task shifting as it is part of practice ( BM &ADMs) and ICM competencies.

Way forward Develop the curriculum SANC Accreditation Training as per agreed model