![]() ![]() ![]() Apparently therefore, different training strategies will be associated with different costs and there is need to combine cost effectiveness, learning outcomes, and alignment with national strategy in order to inform better policy decisions. Īpart from high cost of training generally, traditional off-site training can lead to service disruptions due to absenteeism to attend trainings and loss of personal income. It has been shown that a strong health workforce leadership is an important factor to ensure motivation and create an enabling learning environment. Therefore it is important that future research on health worker capacity building in Nigeria and other LMICs should include the testing of techniques to enhance knowledge, skills and satisfaction among healthcare workers using appropriately designed and statistically powered studies.įactors known to affect skills and knowledge acquisition including motivation and learning environment, team leadership and communication, and use of simulators to enhance skills retention for low-frequency procedures and others have been explored by various researchers. Even in developed countries where these approaches have been tested, the studies are limited by small sample sizes. Gaps exist in high-quality evidence from Nigeria and other developing countries on the effectiveness of simulation-based LDHF/m-Mentoring learning approaches in improving maternal and newborn health and trainees’ satisfaction. The principles of the LDHF approach include:įacility-based peer staff coach others as they practice or engage in interactive exercises after learning to increase compliance and improve performance and outcomes. It also involves brief, ongoing activities (e.g., skills practice, team drills, games, and quality improvement activities) at the job site to sustain learning and support clinical decision-making. The LDHF approach uses in-service learning updates to deliver information based on local needs during short, structured, onsite, interactive learning activities that involve the entire team and are spaced over time to optimize learning. Testing these approaches in LMICs is important to validate if these findings on technique, frequency, setting and media used to deliver instruction are replicable and feasible. However, one of the limitations of this review was the severe lack of quality data from low- and middle-income countries (LMICs). These findings have driven Jhpiego’s shift into simulation and practice-based, shorter but repeated, workplace-based training. It is also known that settings similar to the work environment improved skill acquisition and performance of healthcare workers. Evidence from a systematic review has shown that techniques such as simulation, practice and feedback are more effective than lecture and reading, and repetitive rather than single interventions result in better learning outcomes. While it is important to increase coverage of maternal and newborn care, there is a need to improve the quality of services provided at health facilities. Besides, providers’ turnover due to transfers, resignations, retirements and movement to other sectors also constitute barrier when they involve those who have been trained. When those providers return to their work stations, they often face challenges implementing new or updated skills because the entire team has not been reached which may constitute a barriers. ![]() Additional limitations in numbers of providers that can be trained in a single deployment can mean that only a small proportion of those engaged in delivery of a particular service receive added capacity building and ultimately, impacts on quality of facility services remain unchanged. ![]() This approach to training can be costly, both in terms of individual provider costs as well as with regard to the opportunity costs of removing providers from clinical practice for extended period of time. Ĭurrently, in-service training of healthcare providers in Nigeria has assumed a traditional lecture-based, off-site or classroom approach of just a few service providers per site at a time. Research evidence has shown poor availability of skilled birth attendants in Nigeria and the need for evidence-based in-service training of all skilled birth attendants in order to improve competencies and maternal/newborn outcomes. The competency of frontline birth attendants, particularly on the day of birth care, cannot be over-emphasized, as absence of knowledgeable and skilled service providers may cost lives or result in lifelong morbidity and its consequent socio-economic impacts. ![]()
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