Member/NGO News: Safe Motherhood Clinical Skills: A Self-Paced Learning Intervention for Ghanaian Nurse-Midwives
HealthLink: Issue 118 | 1 December 2002
contributed by: Nancy Kiplinger, Instructional Design Specialist, Intrah/PRIME II
region: Africa
Safe Motherhood Clinical Skills: A Self-Paced Learning Intervention for Ghanaian Nurse-Midwives
Ghana's Ministry of Health (MOH) is committed to scaling-up life-saving skills, postabortion care and family planning services as part of a national safe motherhood program to reduce high levels of maternal and neonatal mortality and morbidity and unmet need for family planning.
The strategy for expanding safe motherhood services builds on a pilot project implemented by the MOH from 1998 to 2000 in three regions with technical assistance from the PRIME and PRIME II projects. Funded by USAID and coordinated by the Intrah program of the University of North Carolina's School of Medicine, PRIME is a partnership dedicated to improving the quality and accessibility of primary-level family planning and reproductive health-care services throughout the world.
During the pilot project's first phase, many nurse-midwives were not able to complete their practical training due to a combination of low caseloads of appropriate clients and too many trainees in training sites at one time. In addition, the residential training course kept providers away from their facilities for at least three weeks, thus restricting access to services. To address these issues, PRIME II helped to design a self-paced learning (SPL) approach as an effective and sustainable way of preparing providers to offer services consistent with performance expectations and service standards.
The design of the SPL program draws on Intrah's expertise in such alternative training approaches as self-directed and distance learning, the American College of Nurse-Midwives' designs for life-saving skills programs, and JHPIEGO's experience with on-the-job training in postabortion care. Development and implementation of the SPL approach has been a collaborative process among PRIME II, the Family Health Division and the Health Education Unit of the MOH, and other in-country partners.
The SPL approach combines:
Self-directed learning; print-based modules; effective facilitation and a strong learner support system, including learning teams;
Sufficient opportunities for learners to practice, receive feedback, and become competent in safe motherhood clinical skills;
Follow-up and supportive supervision by Regional Resource Teams to ensure providers' application and retention of skills on the job.
PRIME II, the MOH's Health Research Unit, and the Population Council/Frontiers Project are joining forces to conduct an operations research study to compare the costs and impacts of the SPL approach with the standard three-week residential course. Based on results and recommendations from that study and an evaluation of the SPL materials, the MOH anticipates making decisions about further scale-up of the national safe motherhood program. PRIME expects to use the results to fine-tune the approach and materials for future use in Ghana, as well as other countries and regions of the world.
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