helping mothers survive: bleeding after birth
DESCRIPTION
An Innovative training approach bringing competency-based training to the frontline to help mothers survive the day of birthTRANSCRIPT
Helping Mothers Survive: Bleeding a6er BirthAn innova8ve training approach bringing competency-‐based training to the frontline to help mothers survive the day of birth!
Cherrie Lynn Evans, DrPH, CNM Senior MNH Advisor
Global Alliance for Nursing and
Midwifery February 2014
Today’s Agenda!
! What is “Helping Mothers Survive”?!
! Why do we need another training?!
! The evidence for this training style!
! Development and testing!! Ongoing practice is key!!! Where it is being used!! How to get involved!! Resources!
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What is Helping Mothers Survive?
! Series of modules on leading killers!1st Bleeding after Birth!
! Similar in look and feel to Helping Babies Breathe!
! Facility based training and practice"
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• One-‐day training • Onsite • Hands-‐on learning • Simula4on • Scenario prac4ce • Highly graphic materials
Why do we need this?
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Helping Mothers Survive:"
Bleeding after Birth"
Why do we need this?
! AMTSL – Uterotonic use in 3rd stage!
! Quality of care surveys in 6 countries 2009-2011 showed that fewer than 29% of women received AMTSL to standard.!
! Traditional training approaches don’t reach everyone!"
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Innova4ve solu4ons
Efficient and
effec4ve
Acquisi4on of
knowledge and skills
Change prac4ce
In-‐Service Training
What makes in-‐service training effec4ve?
Technique
Loca4on
Timing Media
Loca8on
Timing
Media Print • Texts • Job aids Live
Audio/Video
Mobile messaging
Computer -‐ Off-‐line, Online, Real 4me
Technique Passive • Lecture • Reading
Par4cipatory • Games • Team-‐based • Self-‐directed • Case-‐based • Simula4on
The Key Component?
Technique
SeSng
Timing Media
We need….
Reading
Lecture
LESS
MORE
Simula8on
Prac8ce with Feedback
Case-‐based
Helping Mothers Survive Stakeholders
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Competencies
1. Ac8ve Management of Third Stage of Labor
2. Simplified management of PPH
Helping Mothers Survive is Highly graphic
Uses Mul8disciplinary Small Groups
Emphasizes Simula8on
Change in prac8ce
Mother and Newborn are a unit
Train ALL authorized providers
Highly graphic materials
Short & sweet
Interac8ve simulators
Shared facilita8on of prac8ce
HMS Training – Concept
“Low dose, high frequency”
prac4ce
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Low-Dose, High-Frequency Practice!
Definition – !Case-based scenarios!Hands on simulation!Participatory!Team-based or pairs!
!Timing – !
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Evidence for Helping Mothers Survive?!
BAB Knowledge Assessment: By Country Average Scores Pass Rate
Pretest Post-‐test
p-‐valuea
Pre-‐test
Post-‐test
p-‐value
Total 76% 89% *** 71% 94% *** India (n=47)
70% 87% *** 45% 89% ***
Malawi (n=44)
83% 93% *** 100% 100% n/a
Zanzibar (n=26)
75% 87% *** 70% 92% *
a *p<.05 and ***p<.001
HMS Field Test -‐ Findings 25 item test -‐ validated by 60 SME
3 skills sta4ons – validated by 60 SME
Pass Rate
AMTSL (11 items)
Retained Placenta
(7 items)
Bimanual Uterine Compression (12 items)
Total 83 89 85
India 82 88 90
Malawi 83 90 79
HMS Field Test -‐ Findings
Self-‐Reported Confidence in Skills*
Before Training
Amer Training
p-‐Value
Providing AMTSL 3.3 4.1 p<.001 Managing PPH 3.1 3.9 p<.001 Performing bimanual uterine compression
2.9 4.0 p<.001
*Likert scale: 1 = “I cannot perform this skill” 5 = “I am extremely confident”
HMS Field Test -‐ Findings
Global Distribution of HMS Training!
700+ trained 48+ countries
28!
Saving Lives at Birth -‐ Uganda • HMS training at facili4es – 8 weeks of prac4ce
• HBB training at facili4es – 8 weeks of prac4ce + 4
Pair HMS and HBB in 12 districts and measure health outcomes of
mothers and babies
Where next?!
! ICM!! FIGO!! UNFPA!! UNICEF!! Faith based organizations!! Academic institutions!! Ministries of Health!! Professional bodies!!
How can you get involved?!
Learn more!www.helpingmotherssurvive.org!!
!
How to Become a Helping Mothers Survive Trainer!
Thank you!!
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