Safe Motherhood in Nepal

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Post Training Follow up for Skilled Birth Attendants

During June and July 2009, SSMP worked with the National Health Training Centre (NHTC) to pilot an intensive post training follow up programme for Skilled Birth Attendants (SBA). A total of 119 SBAs, mainly nurses and Auxiliary Nurse Midwives (ANM) were followed up at 38 health facilities by trainers from five training sites. Key positive findings were that most trainees were using their new life-saving skills and were confident and competent in providing delivery and emergency obstetric care services. The trainers also found the exercise a very useful opportunity for learning about the professional realities of rural nurses and ANMs, enabling them to better train and support SBAs in the future. SBAs and their supervisors commented that more supportive supervision was required from training sites to help SBAs retain and further develop their skills, and that for some skills opportunities for clinical practice during training need to be increased. It was also observed that some supervisors are not clear about what a trained SBA can do, and as a result either feel unable to provide the necessary support or may even prevent the SBA providing services. These and other findings are being used to improve the SBA training and support system, including scaling up the exercise into a national SBA follow up programme.