The midwifery curriculum at the National University of Samoa's (NUS) had not been updated since 2011.  Crucial topics such as family planning, gender-based violence (GBV) etc. were barely addressed, leaving midwives without the current knowledge and skills to effectively serve their communities, especially women and young girls. However, behind the scenes, three remarkable women — Alovale Sau, Head of Midwifery School, Mele Tafaeono, Senior Lecturer, and Jyothi Abraham, Senior Lecturer and Head of Midwifery Programme refused to let the programme fall into irrelevance. With years of practical experience guiding them, they became unofficial innovators, quietly integrating vital topics like gender-based violence (GBV), emergency response, and neonatal care into their teaching. Their students were getting the real-world knowledge they needed, but on paper, it was as if these crucial updates didn't exist.

Samoa, a small island nation with a population of a little over 100,000 and around 57,000  women of reproductive age, has only 77 registered midwives, and a staggering 27 of them are nearing retirement. With health workers leaving the country and service demands on the rise, the already short-staffed Samoan health system is under immense pressure.

 There is a consistent shortage of health workers, especially midwives, in our country due to out-migration, said Mele Tafaeono. There was, therefore, an urgent need to train more midwives on a revised  curriculum that offered  updated knowledge and skills.

 In 2021, National University of Samoa approached UNFPA to support the  curriculum revision. Through its Transformative Agenda (TA) Programme funded by the Australian Government, UNFPA stepped forward to support a full curriculum review. UNFPA engaged the Burnet Institute for a technical review and the updated course introduced several game-changing elements including:

• Blended learning through moodle and remote delivery, allowing students from other islands in Samoa to study without financial strain.
• Block teaching for clinical placement, ensuring students now follow mothers’ full care journeys and gain deeper clinical experience.
• Expanded curriculum that includes dedicated research training and separates complex topics like contraceptive counselling and services including long acting contraceptive services, gender based violence (GBV), and reproductive complications into manageable, focused modules.

UNFPA helped us with funds as well as technical support through Burnet Institute, Jyothi Abraham explained. The funding also enabled us to hire additional lecturers. Our programme initially had only two lecturers for four courses per semester, so this support was critical.

The collaborative effort paid off. In April 2025, the first cohort of eight midwives under the revised curriculum graduated. These graduates are now working as midwifery interns  in hospitals and health centres across Samoa. This is not just a symbolic achievement; it’s a tangible step toward rebuilding the nation's midwifery workforce.

At the maternity ward of the Tupua Tamasese Meaole Hospital in Apia, a young mother in her eighth month of pregnancy is having an ultrasound. Juliana Sili, one of the eight newly graduated midwives, is on duty. She's had a busy morning, and her training is proving invaluable.

The skills and knowledge I learned during my midwifery course are apt for my job here at the maternity ward, Juliana shared. Sexual and reproductive health (SRHR) was a very important aspect of my training as a midwife, and it is not only helping me to provide family planning services to clients, but I am equipped to counsel young people on SRHR information and create awareness.

Juliana and her cohort are more than just graduates; they are the future of health care in Samoa, trained and ready to provide critical SRHR, and maternal and newborn care services to women and girls in Samoa.