An innovative approach to in‐service training of maternal health staff in Cambodian hospitals

Woods, Joan; Gagliardi, Laina; S, Nara; Phally, Sim; Varang, Ouk; Viphou, Nget; Grundmann, Christophe; Liljestrand, Jerker

doi:10.1016/j.ijgo.2014.10.034

Cited by 11 publications

(19 citation statements)

References 19 publications

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“…Harerimana showed that a comparison between a single longer training (11 days) and a shorter training (6 days) showed no difference in nurses’ ability for classification and treatment of childhood illnesses 20. Many studies endorsed the importance of short, repeated education as a strategy leading to greater retention of knowledge and skills 21–24…”

Section: Resultsmentioning

confidence: 99%

Continued nursing education in low-income and middle-income countries: a narrative synthesis

et al. 2020

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IntroductionContinued nursing education and development can reduce mortality and morbidity of patients and can alleviate the shortage of healthcare workers by training of nurses for high-demand skill sets. We reviewed patterns of educational interventions and strategies in initiating behaviour change, improving patient outcomes or knowledge for nurses in low- and middle-income countries (LMICs).MethodsThe study searched the MEDLINE (PubMed), Embase, CINAHL, Google Scholar and Web of Science databases. The study included interventional studies on continued nursing education from 2007 to 2017. Of the 6216 publications retrieved, 98 articles were included and analysed by three independent reviewers.ResultsOf the 98 studies that met inclusion criteria, five were randomised controlled trials, two were qualitative in design and the remaining 91 were quasi-experimental, before-and-after studies. Of these studies, the median sample size of participants was 64, and the majority were conducted in Asia (53.1%). During the 10-year study period, 20.4% was conducted in 2015, the highest proportion, with a general increase in number of studies over time from 2007 to 2017. Main themes that arose from the review included train-the-trainer models, low-dose/high-frequency models, use of multiple media for training, and emphasis on nurse empowerment, strong international partnerships, and the integration of cultural context. Overall, the studies were limited in quality and lacked rigorous study design.ConclusionContinued nursing education in LMICs is essential and effective in improving nurses’ knowledge base, and thus patient outcomes and quality of care. Long-term, randomised studies are needed to understand how training strategies compare in impact on nurses and patients.

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Section: Resultsmentioning

confidence: 99%

Continued nursing education in low-income and middle-income countries: a narrative synthesis

et al. 2020

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“…Woods et al 71 evaluated the secondary effects of training in a controlled trial. The investigators measured the skills of birth attendants who had undergone training as well as those who had not; in addition, they measured skills among birth attendants who had not directly undergone training but worked with those who did.…”

Section: Secondary Effects Of Nr Trainingmentioning

confidence: 99%

Newborn Resuscitation Training in Resource-Limited Settings: A Systematic Literature Review

et al. 2016

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CONTEXT: Birth asphyxia contributes substantially to neonatal mortality in low-and middleincome countries (LMICs). The effects of training birth attendants in neonatal resuscitation (NR) on mortality are limited by falloff of skills and knowledge over time and transference of learned skills into clinical practice.OBJECTIVE: This review examined acquisition and retention of NR knowledge and skills by birth attendants in LMICs and the effectiveness of interventions to improve them.DATA SOURCES: Medline, Cochrane, Embase, CINAHL, Bireme, and African Index Medicus databases were searched. We reviewed Web pages and reports from non-peer-reviewed (or "gray") literature sources addressing NR training in LMICs. STUDY SELECTION:Articles on acquisition and retention of NR knowledge and skills, and interventions to improve them, were limited to LMICs. RESULTS:The initial search identified 767 articles, of which 45 met all inclusion criteria. Of these, 31 articles analyzed acquisition of knowledge and skills, and 19 analyzed retention. Most studies found high acquisition rates, although birth attendants struggled to learn bag-mask ventilation. Although significant falloff of knowledge and skills occurred after training, refresher training seemed to improve retention. Results of the gray literature analysis suggest that formal, structured practice sessions improve retention. LIMITATIONS: This review did not analyze training's direct impact on mortality.CONCLUSIONS: Knowledge and skills falloff is a significant barrier to the success of NR training programs and possibly to reducing newborn mortality in LMICs. Refresher training and structured practice show significant promise. Additional research is needed to implement and assess retention improvement strategies in classroom and clinical settings.a Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; b Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts; c Harvard Medical School, Boston, Massachusetts; and d Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah Dr Reisman oversaw the literature reviews, interpreted the results, and drafted the initial manuscript; Ms Arlington assisted with the gray literature search and reviewed and revised the manuscript; Dr Jensen performed the initial gray literature analysis and reviewed and revised the manuscript; Mr Louis and Ms SuarezRebling conducted the initial literature review; and Dr Nelson conceptualized and designed the literature review and reviewed and revised the manuscript. All authors approved the fi nal manuscript as submitted.

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“…Gaps in postnatal care have been identified as an important barrier to improving the continuum of care for improving maternal and newborn health [4]. In Cambodia, maternal mortality has decreased markedly [5], but gaps in equity persist and quality of care remains an important priority [4,6,7].…”

Section: Introductionmentioning

confidence: 99%

Warming the postpartum body as a form of postnatal care: An ethnographic study of medical injections and traditional health practices in Cambodia

et al. 2020

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Postpartum care is a critical element for ensuring survival and health of mothers and newborns but is often inadequate in low-and middle-income countries due to barriers to access and resource constraints. Newly delivered mothers and their families often rely on traditional forms of postnatal care rooted in social and cultural customs or may blend modern and traditional forms of care. This ethnographic study sought to explore use of biomedical and traditional forms of postnatal care. Data were collected through unstructured observation and indepth interviews with 15 mothers. Participants reported embracing traditional understandings of health and illness in the post-partum period centered on heating the body through diet, steaming, and other applications of heat, yet also seeking injections from private health care providers. Thematic analysis explored concepts related to transitioning forms of postnatal care, valuing of care through different lenses, and diverse sources of advice on postnatal care. Mothers also described concurrent use of both traditional medicine and biomedical postnatal care, and the importance of adhering to cultural traditions of postnatal care for future health. Maternal and newborn health are closely associated with postnatal care, so ensuring culturally appropriate and high-quality care must be an important priority for stakeholders including understand health practices that are evolving to include injections.

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An innovative approach to in‐service training of maternal health staff in Cambodian hospitals

Abstract: Key clinical skills in low-resource settings can be improved by implementing CME using simulations and supportive follow-up.

Cited by 11 publications

References 19 publications

Continued nursing education in low-income and middle-income countries: a narrative synthesis

Continued nursing education in low-income and middle-income countries: a narrative synthesis

Newborn Resuscitation Training in Resource-Limited Settings: A Systematic Literature Review

Warming the postpartum body as a form of postnatal care: An ethnographic study of medical injections and traditional health practices in Cambodia

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