Online Program

Task shifting to improve access to emergency obstetric care in health facilities: Building capacity of community health extension workers

Tuesday, November 5, 2013 : 3:00 p.m. - 3:15 p.m.

Amina Aminu, MBBS; MPH, Partnership for Transforming Health Systems Phase II (PATHS2) Nigeria, FCT, Nigeria
Ibrahim Gombe, RN, Partnership for Transforming Health Systems Phase II (PATHS2) Nigeria, Kano, Nigeria
Abubakar Izge, MBBS; MPH, Partnership for Transforming Health Systems Phase II (PATHS2) Nigeria, Kano, Nigeria
Mike Egboh, MPH, Partnership for Transforming Health Systems Phase II (PATHS2) Nigeria, FCT, Nigeria
Kuhu Maitra, MBBS, DCH, MD, International Health Division, Abt Associates, Bethesda, MD
Northern Nigeria has one of the highest maternal mortality ratios in the world (up to 2,000 per 100,000 live births) (Adamu et al 2003). A major impediment to improving maternal health and attaining MDGs is lack of human resource capacity and availability in rural areas. One of the critical interventions of safe motherhood initiatives is the presence of a skilled health care provider with midwifery skills at birth. In several communities, Community Health Extension Workers (CHEWS), though not recognized as skilled birth attendants, are the only health care providers available to conduct deliveries in hard-to-reach areas. The Partnership for Transforming Health Systems (PATHS2) programme is building capacity of CHEWs in northern Nigeria through Advanced Life Saving Skills (ALSS) trainings. In this study, 94 CHEWS in Kano state were trained on ALSS using a competency-based approach which consisted of new curriculum development, a four week training of trainers and a three week step down training of CHEWS. Follow-up supportive supervision was also conducted for the trainers and CHEWS. Results show that CHEWS knowledge and skills to provide Emergency Obstetric Care increased from 45% to 75%. CHEWS conducted 2,350 deliveries in 22 facilities after receiving ALSS training. The competency-based training for these lower cadres of health care providers closed the gap in knowledge, skills, and attitudes and lead to improved quality of services delivered at health facilities where other higher-level trained providers were not available.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Describe the role of CHEWS in Nigeria as key players in reduction of maternal and newborn mortality. Demonstrate the impact of Advanced Life Saving Skills training of CHEWS in increasing coverage of emergency obstetric care

Keyword(s): Community Health, Training

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been responsible for leading the service delivery unit of the DfID-funded Partnership for Transforming Health Systems Phase 2 in Nigeria. As part of our service delivery approach, we build capacity of CHEWs to provide quality Emergency obstetric care services in selected states of Nigeria. My main interest in public health sciences is developing and implementing strategies that improve access to quality care for women and cildren in underserved populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.