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Introduction Strategy
Background Results
To achieve the Millennium Development Goal # 4 and 5, one of the strategies being implemented is competency building of service providers with regard to maternal and neonatal health issues. However, these trainings have little impact without the establishment of an effective system of post-training follow-up and supervision
Introduction Strategy
Background Results
Goals/objectives
Lessons learned
Maternal Mortality
MMR: 498 per 100,000 live births (DHS) Ranked 141 out of 181 countries (Hogan 2010 Lancet) Major causes of maternal death (EmONC survey 2010):
Hemorrhage: 39% Prolonged labor: 22% Infection: 20% PE/E: 15%
We improve providers competency to take care of these main causes of maternal and neonatal deaths 3
Introduction Strategy
Background Results
Our strategy is to improve the competencies of providers posttraining by supporting them to maintain their level of acquired skills and thus offer a better quality of services. The approach consists of performing at least 2 post-training follow-up visits on a monthly basis after the training.
Introduction Strategy
Background Results
Historically in Madagascar, trainings of service providers has had unsuccessful results in building competency and increasing the use of new essential skills. Despite training evaluation results showing the acquisition of new skills by providers, in many cases these newly acquired skills were not appropriately applied. The MCHIP project explored the factors leading to the training failures and found that one reason has been the absence of adequate follow-up by the trainer or the coach in the workplace
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Introduction Strategy
Background Results
Established standard : conduct a followup or supervisory visit after 3 months of training. MCHIP found that this follow-up was not held for various reasons such as the lack of resources (no budgeting) and availability of coaches. Even in cases where the follow-up took place, the newly trained provider was not readily capable of applying the skills because he could not convince his direct supervisor to allow him to do so, or did not yet feel safe to perform the skills by himself.
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Introduction Strategy
Background Results
MCHIP's innovative approach was to introduce two post-training follow up visits on a monthly basis after the training. These visits offer an opportunity to reinforce skills and to follow-up on the trainee's action plan for mentoring. This approach allows for a rapid appraisal of any challenges or problems with the new skills as well as the opportunity to remedy them and build confidence and maintain competency in the provider
Introduction Strategy
Background Results
Miarinarivo
95.2
93.95
Follow up 2
The space of one month is respected and the result shows a loss of 7.3 points on the first follow up and 1.25 points on the second.
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Introduction Strategy
Background Results
95
Ambatondrazaka
95
94
93
92
91
90
89
88
87
Training
Follow
up
1
Follow
up
2
90
Training
Follow
up
1
Follow
up
2
93.67
The space is two months : the result shows a loss of 1.33 points on the first follow up and 5 points on the second
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Introduction Strategy
Background Results
Toamasina
92
83
Follow up 2
The space is more than three months between the training and the first follow up and 1 month between first and second follow up: the result show a loss of 34 points on the first follow up and 9 points on the second follow up. 10
Introduction Strategy
Background Results
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Introduction Strategy
Background Results
Other organizations working in Madagascar have taken notice of these results and have begun budgeting and implementing timely post-training follow-ups. Providers who have benefitted from this new approach report high numbers of skills application, and report feeling more motivated and competent to apply effectively what they have learned.
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Introduction Strategy
Background Results
To maintain the level of competency Provide site anatomical models Provide job aids
www.mchip.net
Mer ci !
Misaotra !
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