As part of this intervention, The Antara Foundation (TAF) focuses on enhancing ill-equipped public health facilities and training low-skilled medical workers in high caseload delivery points. Nurse mentoring involves a comprehensive six-week training cycle that is imparted to the labour room staff of these facilities. The training ranges from labour room organisation to complication management. The nurse mentors use a combination of theoretical and bedside teaching methods with the help of simulations on models. Clear protocols are displayed in each labour room, and a thorough check is carried out to ensure that they adhere to government guidelines.
We also work to create master trainers among government supervisors who can cascade training within their blocks, and train labour room staff on a regular basis.
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The nurse mentoring program was carried out in high case load delivery points in Jhalawar and Baran districts in Rajasthan, and is now being implemented in Mahasamund district in Chhattisgarh
As part of the Akshada program in Rajasthan, the nurse mentoring program was carried out in five high-case load delivery points each across Jhalawar and Baran districts, covering around 60% of the total public health institutional deliveries. The intervention also focused on setting up mini skill labs, analysing data trends from live delivery observations and tracking improvement in outcome indicators related to complication management. Other non-mentees, not part of the direct six weeks training, were also provided on-the-job training by our nurse mentors based on their knowledge assessment. These steps have created an environment for the program to self-sustain.
While the initiative continued through the government system in Baran, our monitoring efforts focused on Jhalawar district. The status of the program in Jhalawar is as below:
- Completion of training of nurse mentees from five high case load delivery points
- Initiation of mini skill labs in all blocks
- Over 200 live observations by the TAF team for deliveries conducted by trained nurse mentees
In late 2018, the state team visited one of our intervention facilities in Baran and commended the knowledge and skills of the staff nurse there, as well as the organisation of the labour room. The staff nurse voiced her appreciation towards the Akshada program and our team of nurse mentors.
The solution is now being implemented in Bagbahara block, Mahasamund district as part of TAF’s Aadhya program in Chhattisgarh. Based on our assessment conducted across 24 Sub-health Centre (SHC) labour rooms in the block, we decided to prioritise labour room strengthening. Training on labour room organization has been conducted for all SHC delivery point ANMs on government protocols. Follow up and technical assistance is being provided to selected 12 high case load delivery points.