Boosting the Skills of Health Workers in Remote Areas

In its most resource-intensive phase of program development, One Heart World-Wide (OHW) implements health education programs to better manage the most common conditions of pregnancy, childbirth and newborns. The training programs are implemented in parallel with OHW’s Health Facility Improvement and Community Empowerment and Health Education for Families programs, in collaboration with the Government of Nepal.

One such program is the two-month intensive skilled birth attendant (SBA) training course, most recently held at Dhulikhel Hospital from May 31 to July 28, 2017.

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The SBA training course, which is at the heart of OHW’s training programs aimed at boosting the skills of health workers at remote health posts, trained 10 healthcare providers from the Dhading and Sindhupalchok districts.

The head trainer of the program, Subasna Shrestha, explains that the course is designed to provide training along a continuum of care, from pregnancy through the newborn period, and from the household level to the referral hospital level. The training is comprised of three weeks of theory-based instruction, followed by practical classes. Then, participants must pass written and skills tests. The course focuses on identifying high-risk factors, providing basic care and determining when to make referrals.

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“Forty-one percent of pregnancy-related deaths occur on the way from low-resource settings to referral centers,” says Shrestha. “This training focuses on that time period, especially on preventing deaths due to postpartum hemorrhage and preeclampsia. The SBAs deal with different cases, learn to use new equipment, and learn to detect and manage abnormal conditions using training dummies.”

Sharmila Chhatkuli, 21, has worked as an auxiliary nurse midwife for two years at the Salbas Health Post (HP) in Dhading. She had often struggled to manage complicated pregnancy and child delivery cases in the past. After participating in the SBA training course, she feels confident about handling, managing and referring those types of cases.

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Salbas HP will now have a full-time trained SBA in Chhatkuli, who says that the training has not only supported her with next-level knowledge and skills, but also fueled her dedication to caring for mothers and newborns. She is eager to begin putting her knowledge and experience to use when she returns to work at a birthing center that was supported by OHW.

“The first thing that I am going to do is orientation and training for other medical staff at my HP,” she says. “Now that the course has helped me better understand the intricacies of pregnancy complications, I feel more confident and motivated about my work.”

So far, OHW has trained 2,987 community outreach providers, 4,571 local stakeholders, and 324 SBAs. We have upgraded 190 birthing centers, constructed two maternity waiting homes, and served 6,418 individuals through health camps in districts across Nepal. We are aiming to reach more than 56,000 mothers in 2017 through the Network of Safety model.