Dr. SHIMPUKU Yoko, a professor at Japan’s Hiroshima University, contributed to the creation of Tanzania’s first midwifery master’s degree program, and is also committed to upgrading the quality of childbirth care in that country. Midwives educated in this program physically and emotionally support expectant mothers, enhancing their childbirth experience and leading to a decrease in mortality rates among both newborns and their mothers.
Because girls who give birth at a young age are expelled from school and often find themselves isolated, Dr. SHIMPUKU Yoko focuses on efforts to educate adolescents on pregnancy and reproductive health.
It was a chance encounter that took a young Japanese midwife to Tanzania for the first time. After working in Japan, Dr. SHIMPUKU Yoko went to the United States for a doctoral course in nursing at the University of Illinois Chicago. An anthropology class on breastfeeding and human evolution brought her into contact with a professor who invited her to participate in a research project regarding maternal and child health in Tanzania. Shimpuku had been drawn to Africa by photographs that she saw during the course, so she agreed to join the project without hesitation. The next year, 2008, found her in Tanzania.
The focus of the project was a farming region six hours from Arusha, the country’s second largest city. There, Shimpuku witnessed the harsh conditions surrounding childbirth in Tanzania, and the experience changed the course of her own life. “The healthcare environment was not adequate at all: pregnant women often died en route to facilities. There was nothing we could do, and it made me feel so helpless,” she recalls sadly.
Much of the problem lay in the paucity of medical staff. Doctors tend to be concentrated in large cities, whereas in rural areas, a single midwife may often be responsible for a disproportionate number of births. If increasing the number of doctors was too difficult a hurdle to overcome, Shimpuku thought, the only option was to train specialists in midwifery—leaders of the profession who could pass on their specialized knowledge.
Midwives receive training for fetal ultrasonic examinations.
After returning to Japan, Shimpuku became an assistant professor at St. Luke’s International University in Tokyo, and through exchange programs involving Tanzania and her university, she helped develop a midwifery program that would form the basis for educating the country’s future leaders in the field. Then in 2014, Tanzania’s first midwifery master’s program came into being, at the Graduate School of Muhimbili University of Health and Allied Sciences, located in the country’s biggest city, Dar es Salaam.
Shimpuku’s emphasis has not only been on saving lives, but also on providing pre- and postnatal care that focuses on women’s feelings. Many women of the region traditionally choose to give birth at home because care offered in medical facilities is far from satisfactory, with many hospital beds lined up in a row, for example.
Given those circumstances, Shimpuku was gratified to see how midwives learned the importance of pre- and postnatal care and acted assertively to improve the childbirth environment at hospitals by taking such steps as installing curtains around the beds for privacy and listening to and empathizing with the individual pains of expectant mothers.
Midwives can use the app, co-developed by Shimpuku, for self-study on their smartphones and tablets. The app is based on WHO guidelines for childbirth care and has been enhanced to make it more applicable to clinical practice.
She also co-produced a tutorial smartphone app that aids self-education in midwifery in Tanzania. “The app is based on WHO guidelines, and we added illustrations and videos to make it more useful for clinical practice,” she explains. The app also features an interactive function with which participants can share techniques and experiences. Midwives praise the app as a means of support.
In recognition of Shimpuku’s efforts in Tanzania, WHO and other organizations named her as one of the world’s “100 Outstanding Women Nurse and Midwife Leaders” in 2020.
Shimpuku, who currently serves as vice president for international public relations at Hiroshima University and as a professor at its Graduate School of Biomedical and Health Sciences, says that her long years of aid work in Tanzania have given her a new awareness of the respective merits of giving birth in Japan and Tanzania. “I confirmed my belief that Japanese midwives are conscientious about making birthing mothers feel at ease. Healthcare is not merely a matter of treatment and procedures—emotional care is also important,” she asserts.
She continues, “On the other hand, there is not much support for women in Japan after childbirth. One wonderful aspect of Tanzania is the way in which large families and the wider community come together to support women in childbirth and childcare. We should emulate the merits of both societies and make childbirth a positive experience for as many women as possible. This is what I consider to be my mission.”