Competency-based training "Helping Mothers Survive: Bleeding after Birth" for providers from central and remote facilities in three countries.
OBJECTIVE
To validate a new training module for skilled and semiskilled birth attendants authorized to provide care at birth-Helping Mothers Survive: Bleeding After Birth (HMS:BAB)-aimed at reducing postpartum hemorrhage, the leading cause of maternal mortality worldwide. BAB training involves single-day, facility-based training that emphasizes simulation of scenarios related to prevention, detection, and management of postpartum hemorrhage.


METHODS
A total of 155 skilled and semiskilled birth attendants participated in training in India, Malawi, and Zanzibar, Tanzania. Knowledge and confidence were assessed before and after training. Skills and acceptability were assessed after training.


RESULTS
Knowledge and confidence scores improved significantly from pre- to post-training among all cadres in all three countries. The proportion of providers with passing knowledge scores increased significantly from pre- to post-training among all cadres except for those already high at baseline. On three post-training skills tests the overall proportion of individuals with a passing score ranged from 83% to 89%.


CONCLUSIONS
BAB training in prevention and management of postpartum hemorrhage increased knowledge and confidence among skilled and semiskilled birth attendants. Further studies are needed to determine the impact of this training on skills retention and clinical outcomes following postpartum hemorrhage, after broader implementation of the training program.
Jhpiego - An affiliate of Johns Hopkins University, Maternal and Newborn Health Unit, Baltimore, USA. Electronic address: cherrie.evans@jhpiego.org.
Cherrie L
CL
Evans
Jhpiego - An affiliate of Johns Hopkins University, Global Learning Office, Baltimore, USA.
Peter
P
Johnson
Jhpiego - An affiliate of Johns Hopkins University, Monitoring and Evaluation Unit, Baltimore, USA.
Eva
E
Bazant
Jhpiego - An affiliate of Johns Hopkins University, Clinical Services and Training Office, Dehradun, India.
Neeta
N
Bhatnagar
Jhpiego - An affiliate of Johns Hopkins University, Family Planning and Reproductive Health Unit, Lilongwe, Malawi.
Jane
J
Zgambo
Jhpiego - An affiliate of Johns Hopkins University, MNCH Department, Unguja, Zanzibar, Tanzania.
Asma R
AR
Khamis
D003162:Competency-Based Education; D005260:Female; D006801:Humans; D007194:India; D008295:Malawi; D008427:Maternal Health Services; D008880:Midwifery / Q000193:education*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D019035:Rural Health Services; D013636:Tanzania
Birth attendant; Competency maintenance; Continuing professional development; Maternal mortality; Postpartum hemorrhage; Simulation; Skilled birth attendant; Training