Retraining of CHC Midwives in Nghe An Province 

Nghe An MCH/FP Center 
JICA Reproductive Health Project, Phase II


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I. Issues 

Current situation of the staffs in charge of delivery attendance at commune health centre in Nghe An Province: 

・Qualification/professional levels of these staffs are not standardized because of 

 - Various training levels 
 - Insufficient training for primary midwives while there is a high rate of this group 
 - Gap between knowledge and skills of midwives 
 - Little retraining after graduating from schools


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II. Objectives of training 

1. Midwives will be able to provide safe and hygienic delivery attendance. 
2. They will be skillful in using HBMR to detect early abnomalities during pregnancy, delivery and within 42 days after delivery. 
3. They will be skillful in using partogragh. 
4. They will well carry out recording and reporting and IEC activities. 
5. They will know how to use clean delivery kit. 
6. They will be able to provide guidance to hamlet health workers. 


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Ⅲ. Results 

・From 2 Mar. 1998 to 30 M ar. 2002, 17 retraining courses have been conducted. The 18th Course is in progress. 
・407 C H C staffs joined 17 courses. In average, each course has 24 participants.


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Summary of participants by age groups 

20-24: 25 (6%) 
25-29: 91 (22%)
30-34: 92 (23%)
35-39: 79 (19%)
40-44: 66 (16%)
45-49: 32 (8%)
5054: 6 (1%)


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Summary of participants by qualification 

Primary midwife: 43% 
Secondary midwife: 19% 
Primary nurse: 2%
Secondary nurse: 1% 
OB/GYN As. Dr.: 27% 
General As. Dr.: 8% 


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Number of participants passed post-tests 

Passed: 399 
Did not pass: 8 


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Average scores of knowledge and skill tests by qualification 

Secondary level Pre-test
  Knowledge: 49 
  Skills: 35 

  Knowledge: 36 
  Skills: 30

Secondary level Post-test
  Knowledge: 83
  Skills: 85

  Knowledge: 66 
  Skills: 69


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CHC Monitoring activities 

Experience Sharing Seminar 
August, 2002


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Purpose 

- To identify and improve the To sustain and develop quality of the activities of CHC staffs 
- shortcomings/problems of CHCs 
- To develop the strong points of CHCs
- To improve RH services


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Major sections in CHC monitoring checklist 

- Basic data of the monitored commune and CHC Hygienic condition 
- CHC's facilities 
- Utilization and maintenance of equipment 
- Pregnancy management 
- Staff management 
- Work plan 
- Recording and reporting activities 
- Test for CHC's midwife (knowledge and skills) 
- Standardized answers of the test


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Monitoring activities of DHC
  Once to each CHC every 1-3 months

Monitoring team 
CHC 
  ↓
・CHC
  - PC
  - WU
  - CHC
・CHC


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Of Project and MCH/FP Center
  Once to each model district every month 

MCH/FP Center 
  JICA expert and staffs of MCH/FP Center 
	↓
Monitoring team 
	↓
		   DHC
Monitoring team ← Monitoring 

staff of DHC 
		← District WU 
	↓
DHC 
Commune PC 
Commune WU


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Post-monitoring examination

Monitoring team of DHC → CHC
		       → CHC
  Have CHCs solved thedentified problems? 


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Categorization of identified problems 

Hygiene: 17% 
Facility: 19% 
Equipment: 7%
Pregnancy Management: 11% 
Staff management: 8% 
Work Plan: 15%
Recording/reporting: 12%
Knowledge/Skills of midwife: 11% 


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Problem solved by CHCs after monitoring visit 
  Summary of post-monitoring examination results 


Problems identified at monitoring visit: 1705 
Problemssolved: 1409


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Thank you!