Training, registration necessary for postnatal care practitioners

KUALA LUMPUR – As confinement centres sprout up nationwide to meet the needs of mothers and babies after childbirth, there is growing concern over their safety and the competency levels of the staff providing postnatal services.

This is because currently there is no specific law or regulatory body to monitor such centres.

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Confinement refers to the traditional postnatal practices that are observed after childbirth for 30 to 40 days. Mothers have the option of hiring a nanny or pui yuet to take care of them and their newborn baby in their own home or checking into one of the many confinement centres that offer services encompassing a mix of modern and traditional practices.

However, the days of hiring untrained and unaccredited staff to save costs are over for confinement centres as the Traditional and Complementary Medicine (T&CM) Act (Act 775) was updated in March this year to make it compulsory for all T&CM practitioners – including postnatal care practitioners – who do not possess any qualification but have the relevant experience to take a one-year course to meet the minimum qualification to register as a T&CM practitioner under Act 775.

According to National Population and Family Development Board (LPPKN) director-general Abdul Shukur Abdullah, the unqualified practitioners have been given two years, beginning March 15 this year, to take the course and qualify for registration.

Once the new ruling comes into effect, businesses offering confinement services can only employ qualified personnel such as midwives and masseurs who are registered with the Ministry of Health under Act 775.

“This is to ensure the quality of the services rendered by postnatal care practitioners and safeguard the rights, safety and well-being of all the parties involved,” Abdul Shukur told Bernama.

Discussions still ongoing

Abdul Shukur said to ensure their safety, it is important for potential clients to take into consideration the accreditation status, experience and background of the staff working in a confinement centre before committing to its postnatal services.

“This is because there is still no specific law to regulate confinement centres,” he said, adding that to date, the government is still in discussions to create such a policy.

“The formulation of this policy will have to involve various parties because postnatal services are not merely confined to caring but also cover modern and traditional medicines, massage, herbal (treatments) and the use of hospital equipment,” he said.

Abdul Shukur said new and experienced mothers are increasingly recognising the importance of observing proper confinement practices in an environment free of any stress or hassle, more so now during the pandemic.

Besides lodging and food for the mother and baby, confinement centres also offer laundry services and 24-hour care by their staff who include nurses and midwives or nannies.

Some centres also provide a range of baby products and also special products for the mothers to use during the confinement period, as well as massage services. Some even conduct classes on how to care for the baby.

“However, where these services are concerned, various aspects have to be considered, such as the pricing, safety of the building serving as the postnatal care centre and the quality of the services,” said Abdul Shukur.

As for enforcement, he said for now it only entails the local authority concerned suspending a confinement centre’s operating licence if it is found to have flouted any rule or has reported a mishap involving a client.

“This is why it is important to introduce a law specifically to monitor them (confinement centres) because in the event of any untoward incident, the premises can be ordered to close and action can be taken against the staff concerned,” he added.

Mamacare programme

Abdul Shukur said besides private postnatal services, mothers can also opt for the reasonably-priced postnatal care packages offered by LPPKN through its wholly-owned company Family Wellbeing Sdn Bhd (FWSB).

FWSB runs the MamaCare programme which provides postnatal care packages through its network of trained postnatal care practitioners all over the country.

Under the MamaCare programme, implemented by LPPKN in 2012, single mothers and elderly women, especially those from low-income households, are provided training in holistic postnatal care. Upon the completion of their training, the women are recruited by FWSB to provide postnatal services to their clients.

Currently, 1,431 women nationwide have been trained under the MamaCare programme and are involved in providing postnatal care services to their clients at their homes, said Abdul Shukur.

“So far, a total of 54,271 women have benefited from the services provided by MamaCare practitioners. It proves that our services are gaining popularity among women,” he said.

He said all MamaCare practitioners have the necessary skills to provide postnatal services such as traditional massage, preparing special food for women in confinement, applying a hot compress on the mother’s abdomen to improve blood circulation and managing babies as they have undergone National Occupational Skills Standard-accredited training at the Social Institute of Malaysia.

“After completing the NOSS training module, the participants qualify for the Malaysian Skills Diploma Level 4 which will enable them to offer their services to the public.

“The syllabus includes health screening, basic counselling and traditional and modern postnatal care,” he explained, adding that all the participants are given a certificate and a set of MamaCare uniform after completing the course.

To qualify for the Malaysian Skills Diploma Level 4, a person would need to possess the Malaysian Skills Certificate Level 3; however, depending on their level of experience in midwifery and postnatal care, women who have no paper qualifications are allowed to proceed to the higher levels.

Regulate private centres

FWSB managing director Rahimah Ibrahim said the MamaCare programme offers 12 prenatal and postnatal packages priced at between RM499 and RM8,999 each.

Apart from these, MamaCare also offers body scrubs and massages to boost the production of breast milk, as well as a special massage package for women who have had a miscarriage.

“All our packages are offered on a day-care basis… there are no overnight stays at the client’s house,” she said.

She said MamaCare also has its own brand of herbal products, herbal baths and bengkung (a corset-style cloth tied around the abdomen) that are used by women during the confinement period, as well as baby products.

Those wishing to obtain the services of a MamaCare postnatal practitioner can download the Mamacare.my application from Google Play or visit https://mamacare.my/mamacare/ or call 018-2935004.

Private postnatal care provider Esther Postpartum Care Sdn Bhd chief executive officer Datin Kathrina Loh, meanwhile, agreed that the government should formulate a special law to regulate confinement centres, as well as draw up guidelines on pricing, premises and other aspects.

“This is because many such centres are being set up now and we are facing more competition in the market,” she said.

Her centre, opened 13 years ago, offers a mix of traditional Chinese and modern confinement practices, with all its nurses, midwives and postnatal practitioners trained in Taiwan.

Her clientele is mainly Chinese, she said, adding that her centre has not caught the attention of Malay women as they prefer to spend their confinement period at home and observe traditional practices handed down from generation to generation.

“The Chinese usually observe a confinement period of only 28 days, whereas the Malays observe it for up to 44 days,” she said, adding that her centre intends to offer confinement packages tailored for Malay clients in the near future.

Loh said due to its status as a care centre, they do not have doctors on duty full-time. Twice a week, however, a gynaecologist, paediatrician and Chinese traditional medicine practitioner would visit the centre. A general practitioner also makes his rounds two or three times a week.

“If any of our client or baby develops a health complication, we will refer them to the nearest hospital or clinic,” she said.

Her centre charges between RM13,888 and RM33,000 for a 28-day confinement package, depending on the type of package and accommodation.