Post on 29-Nov-2015
description
Helping Mothers Survive Bleeding after Birth: An innovative training approach to prevent and manage PPH
Blami Dao MD, FWACS
Director, MNH, Jhpiego
FIGO Africa Meeting 2013
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Introduction
Reduction of maternal mortality at the global level from 500,000 to 287,000 per year (WHO 2010)
PPH still remains the leading cause of maternal death worldwide (Lancet 2006)
PPH prevention and management = high priority for MNH programs
In many developing countries, health workers are not well-trained to prevent and manage PPH
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Objectives
Describe Helping Mothers Survive (HMS)/ Bleeding after Birth (BAB) materials and training approach
Share country experiences in implementing HMS/BAB
Discuss how HMS/BAB can be used by Ob/Gyns
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HMS/BAB Training Materials
Training package validated through field studies in India, Malawi and Zanzibar
Material highly graphic Four main components
Provider’s guide Flipbook Action plan MamaNatalie anatomic model
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Training Approach
Principles: learning by doing and simulation- based practice
A one-day, skills-building focused training: Active management of third stage of labor PPH management: uterine massage, management of genital
track injury, bimanual compression of the uterus and timely referral
Skills maintained through onsite, short, repetitive practices called Low-Dose, High-Frequency (LDHF) practices led by a peer practice coordinator.
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HMS/BAB Trainer Terminology
TITLE ROLE QUALIFICATIONNational/Regional LevelHMS Champion National advocate
May be preparatory for HMS trainer role
Proficient MNH provider Trained as HMS champion
HMS Master Trainer National advocate Trainer of trainers (HMS) M&E guidance Training commodities support
Qualified master trainer (Jhpiego training pathway or other pathway recognized by the person’s country)
Proficient MNH provider Trained as HMS champion Mentored as HMS trainer of trainers Positioned – association, NGO, government council
District/Facility LevelHMS Trainer District advocate
Introduce initial HMS training module to facility
Select PPC Support LDHF practice
Qualified trainer (Jhpiego training pathway or other pathway recognized by the person’s country)
Proficient MNH provider Trained as HMS trainer Mentored as HMS trainer Trained in PPC selection, training and mentoring
HMS Peer Practice Coordinator (PPC)
Facility advocate Coordinate LDHF practice Coordinate with HMS trainer
Competent MNH provider Trained as PPC Mentored as PPC
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Countries’ Experience
India: XX Trainers + XX Providers in XX districts
Malawi: 62 Trainers + 222 providers in 15 districts
Kenya: 31 Trainers + XX Providers in XX districts
Uganda: 21 Trainers + XX Providers in XX districts
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HMS/BAB and Ob/Gyns
Primary audience = anyone who conducted deliveries
Inclusion in training of Ob/Gyns Residency training Continuous medical education with credits
Ob/Gyns as trainers of other cadres: nurses/midwives, medical students, residents, medical/clinical officers
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Jhpiego-FIGO Partnership
On the 2nd of October, representatives from 7 countries within Africa were trained by Jhpiego on HMS/BAB.
Detailed, country-level action plans for building provider capacity were developed with a view to improving the quality of care in delivery services.
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Conclusion
HMS/BAB is a complement of Ob/Gyn training for surgical management of PPH.
Expansion of training in peripheral health centers could decrease the number of PPH that Ob/Gyns have to manage.
MHS/BAB has the potential to reduce PPH prevalence and save many lives.