Lessons Learned: BEmONC training in Liberia after the Ebola outbreak
International Medical Corps implemented a short in-service Basic Emergency Obstetric and Newborn Care (EmONC) training and mentorship project funded by ECHO to support the re-activation of four hospitals in Liberia after the Ebola outbreak. The training project was from June to December, 2015.
A two-week curriculum using a combination of lecture and practice on models was developed based upon existing curriculum and tools from MSF, the RAISE Initiative, and WHO.
Results included: 128 nurses and midwives trained, the training package was handed over to the national Division of Family Health at the MOH and county health/RH teams, and providers reported increased confidence and technical ability.
Due to the health workforce shortages sustained after the Ebola crisis, there were fewer Ministry of Health staff available to participate in the training and follow up mentoring. Eventually, staff from county RH teams were able to assist with training; however, international staff were recruited as mentors whose roles were to act as a resource for hospital ward supervisors/ managers and track learning through mentorship. The shortages of health workers at the facility made it difficult for staff to fully participate in the training and mentors frequently had to fill in as staff providers.
An external evaluation was conducted and key recommendations were:
- Train doctors and primary health care staff from different facility levels at the same time in consideration of referral patterns,
- The MOH staff should be engaged from the beginning to provide supervision/mentoring,
- Ensure timely provision of supplies,
- Consensus needed on who, how and when to use checklists for mentoring and supportive supervision,
- Database for monitoring performance should be set up from the beginning of training,
- Comprehensive post-training follow-up is needed at 3 months,
- Integrate EmONC into pre-service training, and
- Shorten the training to 5 days and increase the amount of time devoted to practicing skills.
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