Sally Findley’s presentation at the 2017 Community Health Worker Symposium in Uganda summarised the development of midwifery skills for community health extension workers (CHEWs) in Northern Nigeria. Three states in this area of Nigeria have the highest child mortality rates in the country, and maternal and newborn mortality remain very high in Northern Nigeria as a whole. The research was carried out by the Women For Health programme.
The Clinton Health Access Initiative (CHAI) developed a three-part training and mentoring programme to upgrade and introduce maternal and newborn care skills for CHEWs. They trained CHEWs on maternal and newborn health competencies in short, focused, didactic lectures, supplemented with clinic-based practical skills training and mentoring for three months on-the-job. This emphasis on practical skills and real-world problem solving as a teaching method was evaluated using pre/post testing for didactic and clinical skills, and competency ranking pre/post-tests were completed for the mentoring stage by mentors and mentees. Self-confidence was also assessed.
The evaluation showed that the average skill level increased in the post-test for both didactic and clinical skills knowledge stages, and both mentors and mentees judged that the mentees’ competency had increased. The clinical practices part of the training programme was found to have the greatest gains in awareness of several stages of birth and complications. Furthermore, key skills in several areas, including the ability to manage high-risk pregnancies and skills in working within a team of other health workers, were associated with higher levels of self-confidence.
The presentation concluded by confirming that of all participants who took the training, CHEWs had greatest gains in knowledge and specific skills, that mentoring was important to change competency levels and confidence, and that the emphasis on practical skill building and mentoring is a successful way to build competencies and self-confidence in CHEWs.