On-The-Job MCH Training

For many professions, the most important training one gets is the one-to-one mentoring that happens with older colleagues while you are actually doing the work. They can be formally supervising you or they can just assist you in keeping out of trouble. For years in medicine, such apprenticeship training produced excellent physicians. While it may not be sufficient it is certainly necessary. The one aspect of current medical training that seems less than appropriate, is the demise of such hands on coaching from experienced members in the field.

In rural remote areas with few opportunities for formal education and training, skilled health workers can be trained effectively in a form of on-the-job training that not only incorporates such coaching but also allows and in the case of women, actually encourages them, to undertake training. Reasons for its success include that on-the-job training can take place to the homes of potential recruits, thus allowing them to remain at home while they are trained, reducing the cost and the barriers imposed by leaving the community. Also it prepares health workers for work within that specific environment. While portability of training is overall a good thing, it negatively impinges on rural areas with a net loss of those trained. For people who plan to stay in that region, training in and for that region make perfect sense. Providing training in the home environment helps to increase educational levels in that area. A career ladder that allows the best to move ahead ensures gifted and hardworking health workers are rewarded. But perhaps the best recommendation for on-the-job training occurs when outside organizations recruit your trainees as part of their workforce.

This has happened at FPHC, where several of the recently trained volunteers have been offered jobs within the government health system, including one at the hospital. It is akin to getting a giant feather in your cap, to have someone you have trained to be recognized as useful in a formal role in the health system.

It means you are doing something right and providing opportunities for trainees including volunteers to provide for themselves and their families and to move into the regular job market. It is rewarding to hear that the women volunteers trained by FPHC continue to provide their services free to their own communities. The services they provide will also be augmented by what they learn in their new jobs.

Congratulations to them!

Photo: Sterilizer at EmOC

Maternal & Newborn Training in Refugee Camps

Mero’s sister-in-law was due to deliver shortly after she completed her training with Frontier Primary Health Care as a Female Health Worker. Most of the deliveries in the refugee camp where she lived, were done in rooms set aside for animals or for bathing. This made the cleaning up afterwards easier. Mero had seen how careful the nurses were about hygiene in the labour rooms. Mero had been impressed by the importance her trainers placed on having a delivery done in clean surrounding.

So Mero shared this new information with her sister-in-law and together they began to prepare a room for the delivery and arranged clean clothes, pads, soap and basins. While Mero and her sister-in-law were preparing the room, other women in the camp were watching them and learning. They admired Mero’s efforts. They were glad Mero would be able to assist them to have healthy deliveries.

The baby was born safe and healthy in hygienic conditions with Mero using her new Clean Delivery Kit. Things were already starting to change in the camp .

45 new TBAs were trained in Akora and Akairabad Refugee Camps in Nowsherra district of Northwestern Frontier Province in Oct and Dec, 2009. Training of these female health workers will ensure women in this remote area of Pakistan have ready access to accessible skilled maternal and newborn care. 32 in Akora and 13 in Khairabad.

A comprehensive community selection process ensures that the female health workers are trusted and respected individuals in their own community who will be allowed to visit women and care for them in their homes. The TBAs are provided with three weeks of interactive training in primary health care with an emphasis on maternal and newborn care. They are coached in to recognize and refer pregnancy complications early and to provide health promotion over the three weeks of their training. More than 15 days is spent in health center labour rooms and first level EmOC facilities of Frontier Primary Health Care.Improvements have already been noticed in Ankora within the first three months since the training was done. New registrations of mothers has increased 25% from 88 in Oct to 101 in Dec. while babies weighed within the 72 hours has increase from 92 to 131 in the same periods. The number of women delivered by skilled workers also increased 30%, from 98 to 127.