Maharashtra, India—More than 170 nurses, paramedics and other health providers increased their ability to deliver quality care to pregnant women, mothers and infants, and handle complications at birth during recent clinical skills trainings led by Jhpiego.
Supported by the John D. and Catherine T. MacArthur Foundation, the hands-on trainings took place in a record 26 days during the months of May and June 2013. The trainings were held at 13 public health facilities across India’s second-most-populated state, Maharashtra.
The program was based on the Indian Government’s Basic Emergency and Obstetric Care Guidelines and had the goal of demonstrating and implementing a training model to strengthen clinical skills in these areas that can be scaled up nationally.
“We have never experienced such a down-to-earth training,” said Savita Patil, a nurse at a maternity hospital in Ulhasnagar. “No one ever taught us like this—you literally held our hands and taught us how to plot a partograph [a decision-making tool to chart the progress of labor], conduct normal delivery and newborn resuscitation. This has made us so much more confident!”
Jhpiego trainers traveled to each facility and conducted the clinical skills sessions on-site to ensure maximum provider participation.
The trainings included demonstrations of how to monitor the progress of labor using partographs; active management of third stage of labor; essential newborn care and neonatal resuscitation; infection prevention practices; prevention, diagnosis and management of postpartum hemorrhage and eclampsia/pre-eclampsia (a hypertensive disorder related to pregnancy and a leading cause of maternal deaths); skills in counseling about reproductive, maternal and neonatal health; and postpartum family planning/postpartum intrauterine contraceptive device (IUCD) insertion.
After the trainings, the following improvements in participants’ skills were observed:
- Nearly all participants were able to correctly use a partograph.
- Providers showed greater confidence in providing essential newborn care and newborn resuscitation; providers resuscitated at least three babies closely following the training.
- Participants’ ability to identify signs of pre-eclampsia and eclampsia improved markedly, as did their knowledge of a correct loading dose of magnesium sulfate (MgSO4), a maintenance dose ofMgSO4 and signs of toxicity.
- Infection prevention practices were implemented.
- Newborn corners were set up and ready for use at all 13 facilities.
- Providers began implementing respectful maternity care and the essential newborn care practice of placing a newborn baby on the mother’s belly, allowing the infant to begin nursing.
Participants were given handouts with essential information pertaining to the trainings, including information on labor, delivery, post-delivery care and management of complications; management of hypothermia; neonatal resuscitation; hand hygiene and infection prevention practice guidelines; family planning and immunization; and performance standards for improving quality of labor, childbirth and immediate postpartum care.
The facilities were also given information, education and training materials developed by Jhpiego, including posters for prenatal and postnatal wards and videos on postpartum family planning and postpartum IUCDs. Each facility also received MamaNatalie and NeoNatalie simulation teaching tools to ensure sustainability of practices and dissemination of health information among the clients who visit.