BEmONC master trainers, Ebonyi

Maternal and Perinatal Mortality are Obstetric and Neonatal tragedies worldwide. Of the global Maternal Mortality occurrences, the vast majority occur in low-resource settings and Nigeria accounts for nearly 20% of the global death. The lifetime risk of dying in Nigeria is 1 in 22 during pregnancy, childbirth or postpartum period compared to 1 in 4,900 in most developed countries. The causes of maternal mortality include pre-eclampsia/eclampsia (PEE), obstructed labor, postpartum hemorrhage, puerperal sepsis and abortion complications.
These causes are preventable when labour is supervised by Skilled Birth Attendants (SBAs). Perinatal morbidity and mortality are closely related to events during pregnancy and labor. The high rate in Nigeria is a result of poor maternal health, sub-optimal care during pregnancy, childbirth, and in the postnatal period. The major causes of newborn deaths are birth asphyxia, neonatal sepsis and prematurity. Universal access to Basic Emergency Obstetrics and Neonatal Care (BEmONC) services is one of the strategies that can reduce these deaths and sufferings. Improving access to quality basic emergency obstetrics and newborn care is critical to reducing these preventable maternal and newborn deaths and is a top priority of the Government of Nigeria (GoN).
Aligning with the commitment of the Federal Ministry of Health and Social Welfare (FMOHSW) to ensure that “no woman dies during pregnancy, childbirth and in postpartum”, Jhpiego, with funding from United States Government through the Department of States in Nigeria is providing technical assistance to GoN to bridge lingering gaps in the capacities of doctors, nurses, midwives, and Community Health Extension Workers (CHEWs) working in MCGL supported Primary Health Care (PHC) facilities with Kebbi State to provide life saving BEmONC signal functions.

This intervention aims to bridge existing gaps in the competencies of PHC facilities healthcare workers to provide BEmONC services and ultimately improve the quality of services for women and newborns during pregnancy, labour, childbirth and postnatal period.

The specific objectives include building the capacity of healthcare workers to provide quality:
1. Antenatal care (ANC) services, including Group ANC, in alignment with the recent WHO guideline on ANC for positive pregnancy experience.
2. Management of labour and childbirth using the national labour care guide (LCG), prevention, early identification and management of prolonged labour/labour obstruction, maternal and fetal distress.
3. Provide essential care for every baby to include skin-to-skin care, delayed cord clamping, cord care using chlorhexidine gel, eye care using 0.5% erythromycin eye ointment, administration of vitamin K for prevention of haemorrhagic disease of newborn, helping baby breathe within the “golden minute” using bag and mask, screening of the newborn for congenital anomalies, support early initiation of exclusive breast feeding.
4. Care for small and low birth weight babies using immediate Kangaroo Mother Care (KMC), signs and symptoms for early identification, immediate care and prompt referral of newborn complications such as neonatal jaundice, neonatal sepsis, respiratory distress, encephalopathy,
5. Prevention and management of obstetrics complications including parenteral administration of oxytocic for the management of the third stage of labour, use of PPH bundle for early identification and prompt management of PPH, use of MgSO4 for treatment of severe pre-eclampsia/eclampsia, use of parenteral antibiotics for prevention and management of puerperal sepsis, manual removal of retained placenta, manual vacuum aspiration (MVA) for evacuation of incomplete abortion, and assisted vaginal delivery with vacuum extractor.
6. Build capacity to improve two-way referral system at the facility level.

In collaboration with Jhpiego staff:
1. Each ad-hoc personnel will participate in a 5-day skills standardization and pre-training planning workshop to be organized by Jhpiego.
2. Conduct an advocacy visit to the SPHCDA prior to the commencement of the training and participate in a post-training debrief of stakeholders.
3. Conduct a 7-day on-site capacity building of an average of 6 healthcare care workers at the PHC, which would include community health extension workers, community midwives, nurses and midwives.
4. Conduct a 4-day follow-up mentoring of the trained healthcare workers to strengthen their confidence and competence in using the newly acquired knowledge and skills.
5. Conduct pre- and post-test assessments for each of the modules of the training package.
6. Submit a comprehensive report at the end of the training and at the end of the mentoring within 5 working days after completion of each task.

Deliverables:
1. Detailed and analysed pre- and post- training scores for each of the trainees for each module of the training package.
2. Detail report of the training and mentoring to be submitted within 5 working days of completion of each task.

• Must be a practicing medical doctor, or registered nurse and/or registered midwife in one of the General Hospitals where Comprehensive Emergency Obstetrics and Newborn Care (CEmONC) training was recently conducted in Ebonyi.
• Evidence of up-to-date annual practicing license issued by either the Medical and Dental Council of Nigeria (for doctors) or the Nursing and Midwifery Council of Nigeria (for Nurses and/or Midwives).
• Acquired at least 5 years post-MBBS, or post-nursing and/or midwifery bedside clinical practicing experience in a secondary health facility in Ebonyi.
• Evidence of successful completion of an onsite hands-on competency-based comprehensive emergency obstetrics and newborn care training (or refresher training) within the last 12 months.
• Evidence of strong clinical facilitation, mentoring or coaching skills.
• Evidence of strong analytical and communication skills.

Communication Skills
Presentation Skills

Facilitation skills