An important reason for high maternal mortality in Pakistan and generally in the developing countries is the use of unskilled birth attendants such as family members and traditional birth attendants. The proposed project will introduce a cadre of community-based health workers, who will meet the international definition of skilled birth attendants. These community midwives (CMWs) will be trained in home-based deliveries, which will significantly increase the proportion of skilled birth attendance in the country.

Community Midwife (CMW)

The Community Midwives are professionally trained Skilled Birth Attendants who are capable of performing a regular home birth in a safe and clean conditions.

The following functionalities are included in the CMW model:
  • Providing specialized care to pregnant mothers and their newborns throughout the maternity cycle and in their own homes, as well as assisting them in self-care.
  • As needed, monitor the pregnant woman’s physical, social, and emotional well-being.
  • Taking suitable action within the constraints of available resources.
  • Providing community education and counseling on healthy practices, as well as assisting families in childbirth preparation and emergency preparedness.
  • Identifying real or expected medical issues that require treatment and making timely referrals.

Following the relevant authority’s professional code of conduct and practicing midwifery within the legal framework.

Objectives of the Implementation

  • To strengthen the country’s existing midwifery and LHV training schools by establishing practical training links with DHQ and THQ hospitals, renovating existing facilities, and establishing domiciliary midwifery links.
  • Implementation of a standardized curriculum recognized by the Pakistan Nursing Council, training and deployment of specialized midwifery tutors, and supply of standard teaching aids to improve the quality of midwifery training in the country.
  • To develop a core group of master trainers for the training of midwifery teachers at the national level.
  • To teach 600 midwifery tutors across Pakistan in the new curriculum for community midwifery education.
  • To promote birth preparedness activities through counseling.
  • To strengthen the registration and accreditation system of the Pakistan Nursing Council through supporting additional staff for quality assurance and monitoring of trainings.
  • Development of a computerized database of midwives at provincial MNCH directorates

Expected Outcomes:

The proposed network of community midwives at the grass root level would play a pivotal role in achieving the following:
  • Increasing the proportion of skilled birth attendants will have a definite impact on reducing maternal and newborn mortality and morbidity through:
  • Establishing linkages, conducting normal deliveries at the household level and is able to recognize complications and takes decision of in-time referrals of complicated obstetric cases to the higher level of functional health facilities.
  • Delivery of quality RH-PHC services at the community level.
  • Established community midwifery schools with regards to human resource and equipment, thus providing a continuum of technical back stopping to the skilled birth attendants.
  • LHWs Support provided through a regular contact with the SBAs would be established by the National Program for Family Planning and Primary Health Care through the LHWs supervisors.
  • Including a socio-culture change in the communities by counteracting the misinformation based on taboos and negative traditional practices.
  • Provide opportunities for gender development and income generation thus helping poverty alleviation.
  • Gradual replacement of TBAs by trained community midwives.


Nursing Examination Board of Punjab, Pakistan Nursing Council


The duration required to complete this degree is 2 year.


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40% Marks in Matric either Arts or Science