		SEARCH:

Home : Where We Work : West Africa Regional Program

Building Capacity in Essential and Emergency Obstetric and Newborn Care from the Clinic to the Community

From 2004-2007, the ACCESS/West Africa program aimed to replicate best practices in maternal and newborn health in four non-USAID presence countries: Cameroon, Mauritania, Niger and Togo. ACCESS worked with the Action for West Africa Region-Reproductive Health (AWARE-RH), Mwangaza Action, UNICEF, Plan and partnering governments to build the knowledge and competencies of doctors, nurses, midwives and anesthetists in essential Emergency Obstetric and Newborn Care (EmONC), as well as to build their training capacity. Interventions in all countries involved a combination of strengthening clinical services and mobilizing communities to seek such services. ACCESS was directly engaged in community mobilization work in Cameroon only, however.

Cameroon: ACCESS developed the Ngaoundere district hospital as a clinical training site, training providers from three districts (Ngaoundere, Tibati and Tignere). Furthermore, strong providers from Cameroon were selected to participate in a Regional Clinical Training Skills course. Having completed this course, these providers were elevated to the level of “candidate clinical trainers.” As such, they organized another clinical training course at Ngaoundere district hospital for service providers including nurses, midwives and doctors from Ngaoundere, Tibati and Tignere districts—all in Adamaoua province. Under the tutelage of an ACCESS master trainer, they successfully completed the three week course for 20 providers from 19 facilities. All of the candidate trainers are currently qualified clinical trainers and serve as a base for a national and sustainable team of trainers in Essential Maternal and Newborn Care. At the community level, ACCESS assisted in the development of community liaison teams from 18 health zones. These teams helped their community strengthen or revive community health insurance schemes and delivered health education sessions on topics such as the importance of antenatal care, vaccination and birth planning.
Mauritania: In Mauritania, ACCESS was able to support the training of providers from Brakna and Gorgol regions. EmONC updates were led by ACCESS master trainers as well as Mauritanian candidate clinical trainers and Mauritanian physicians who had undergone a clinical coaching course in Burkina Faso. A special emphasis was made to work with the gynecologist from Aleg district hospital (the clinical training site) to develop competency in obstetric surgery, including caesarian section, laparotomy and emergency hysterectomy. Finally, upon the request of the Mauritanian Ministry of Health, ACCESS supported the revision and pre-testing of new norms, policies and training materials in emergency obstetric and newborn care. The ministry will bring them to finalization and dissemination.
Niger: Zinder hospital, the clinical training site which ACCESS helped develop, has become a national center for training on maternal, child and reproductive health. Following the ACCESS work in Niger, there are Nigerian EmONC trainers and updated providers. UNICEF, the Niger MOH and other local partners continue to tap into the resources developed by ACCESS for additional training for providers from other areas of the country.
Togo: In collaboration with AWARE-RH and Plan, ACCESS began clinical skills replication of best practices activities in Togo. Following a site assessment trip to Sokode district, ACCESS supported the provision of training materials and equipment including anatomical models which were used in a May 2007 training of providers.