Continuing Professional Development in Maternal Health Care: Barriers to Applying New Knowledge and Skills in the Hospitals of Rwanda

Abstract

Objectives Training healthcare professionals in emergency maternal healthcare is a critical component of improving overall maternal health in developing countries like Rwanda. This paper explored the challenges that healthcare professionals who participated in a Continuing Professional Development (CPD) program on Advanced Life Support in Obstetrics® (ALSO) face in putting the learned knowledge and skills into practice in hospitals of Rwanda. Methods This study used a mixed methods approach to understand the challenges/barriers to applying new knowledge and skills in the hospitals of Rwanda. We conducted thirteen purposive in-depth interviews with ALSO® trainees (nurses, midwives and physicians) complemented with a cross-sectional survey on staff turnover in eight of the nine hospitals in the Eastern province of Rwanda. Results Our study found that trainees do not get enough opportunity to apply the new knowledge and skills in their hospitals and expand to health centers. In part because they are frequently rotating to different departments of the hospital and are not getting the opportunity to train their colleagues to share the learned knowledge and skills. The lack of refresher trainings/mentorship and the high personnel turnover were also reported as a barrier to applying new knowledge and skills. Reasons for staff turnover included pursuing further studies, a better opportunity (job/remuneration), low morale, and family related motives including joining a spouse or better schools for children. Conclusions for Practice Expanding and formalizing CPD training to all the healthcare professionals involved in providing maternal care services would improve the provision of emergency maternal healthcare in Rwanda.

“I cannot say no when a pregnant woman needs my support to get to the health centre”: involvement of community health workers in Rwanda’s maternal health

“…This study was funded by the Maternal, Newborn and Child Health (MNCH) project in Rwanda (2012-2015) through a Canadian International Development Agency (CIDA) grant that aimed to contribute to the promotion of maternal, newborn and child health in Rwanda. The overall study provides insights into the contributions of the MNCH project [9,16]. It gives, through the current research, ideas for future areas of focus in terms of promoting maternal health at the community level in Rwanda and, in particular, the M-CHW program.…”

“…The present paper is based on the findings from M-CHWs' perceptions and experiences on access to maternal health services and their involvement in service provision. The first paper reports on the perceptions and experiences of women [9], whereas the second paper highlights the opinions of health professionals on access to maternal health services at the community level and their experience on service provision after receiving inservice training on maternal health care [16]. This study was funded by the Maternal, Newborn and Child Health (MNCH) project in Rwanda (2012-2015) through a Canadian International Development Agency (CIDA) grant that aimed to contribute to the promotion of maternal, newborn and child health in Rwanda.…”

Effect of a community health worker mHealth monitoring system on uptake of maternal and newborn health services in Rwanda

“…Similarly, Condo et al (2014) identified several other factors (e.g., overwhelming workload and lack of supervision) that could hamper the effectiveness of the Rwandan community health program [25]. This highlights the importance of context and the reality that interventions are rarely implemented with perfect fidelity [26–28].…”

“He lets me go although he does not go with me.”: Rwandan women’s perceptions of men’s roles in maternal health

“…In recent decades, several initiatives have been implemented within countries and regions to promote improved maternal outcomes by reducing maternal mortality and promoting access to reproductive health [1,2,4]. Some of these initiatives include: promoting antenatal care and access to skilled birth attendance, encouraging the uptake of family planning methods, and increasing the number of trained maternal healthcare professionals [5][6][7][8]. Increasing community engagement in maternal healthcare has been another widely-adopted strategy, where community members are actively involved in the implementation and oversight of community-based initiatives that serve to promote better maternal health experiences [9,10].…”