ABSTRACT
The Project for Improving Maternal and Newborn Care through Midwifery Capacity Development by Japan International Cooperation Agency (JICA) was initiated for capacity building through pre-and post-service midwifery training.<BR> Firstly, we have shared the concept of ideal midwifery care based on the definition of evidence-based medicine (EBM) with our counterparts, which involves the integration of the best research evidence with clinical expertise and patient values. In addition to evidence-based midwifery care, we tried to provide individualized woman-centered care. <BR> After sharing these concepts in our project sites, we tried to modify the lectures on the basic concepts of midwifery care in the Health Center Midwifery Training program, and care providers’ attitudes based on EBM in the Basic Emergency Obstetric and Neonatal Care Training program.<BR> Our trial is an essential first step towards the further reduction of maternal mortality in Cambodia.
ABSTRACT
In Bangladesh, the Bangladesh Nursing Council (BNC) legally decides the curriculum for nursing and midwifery education and appoints nurses and midwives.<BR>The BNC had revised the curriculum in 2006, and it is currently educating based on a new curriculum for the Diploma Nursing Course.<BR>In the new curriculum, the BNC aims at strengthening the capabilities of nursing and midwifery professionals according to the care needed by each patient, cultivating the critical thinking skills of these professionals, and addressing the needs of nursing and midwifery based on communities.<BR>However, the shortage of health care professionals cannot be compensated only with the Diploma Nursing Course. Private nursing and midwifery education are being continued as Certificate Nursing Courses.<BR>In Bangladesh, in the stage transitorium of nursing and midwifery education, it will be a subject how health talented people's shortage of quantitative is coped with with strengthening of the education for the quality enhancement of nursing and midwifery from now on.
ABSTRACT
The Republic of Senegal (hereinafter referred to as “Senegal”) became independent from its former colonial master, the Republic of France in 1960 and formed a democracy. Operations of nursing schools that had been established under the colonial rule were taken over by the Senegal government after the independence. Though having been influenced strongly by French nursing education system, they has developed uniquely and now grown to leading nursing schools of francophone West African countries.<br>The objective of this manuscript is to focus on nurses that account to the largest number of healthcare workers in Senegal and to trace the historical transition of Senegal's nursing education. The research methods are collection of reference materials, classification of contents, and interviews. As a result, we found that a visiting nursing school established in 1922 is the oldest public nursing school and a total of eight public schools had been established before the independence. The Senegal government laid down National Economic and Society Development Planning and set forth measures for healthcare problems as a priority issue, and has concentrated on nursing education since the independence in 1960. In 1992, the former Ministry of Social Health Activity established the National School of Health and Social Development by integrating 14 public schools related to health welfare. In 2003, it started a practical nurse training program aimed at increasing of the number of nurse graduates and decentralizing nursing education. In 2010, the nursing education standard was revised to improve the quality of nursing education and it will be applied to all nursing schools hereafter.<br>The need for strengthening management of human resource development and ensuring the quality of that by using the estimates of nurse supply and demand and the like can be suggested as future tasks for the nursing education in Senegal.
ABSTRACT
<b>Introduction</b><br> Even though many oversea training programs end in developing an action plan from what they learned during the course, follow-up opportunities are quite limited. Group training program on maternal and child health for Francophone African countries are conducted in Japan since 2003, organized by National Center for Global Health and Medicine and funded by Japan International Cooperation Agency. Follow-up activities in Senegal and Benin are reported with lessons learned.<br><b>Methods</b><br> Training organizer team made a semi-structured interview with 11 trainees, 6 superintendents and 4 Japanese advisors, asking “Do trainees implement what they planned at the end of the training course in Japan? If not, what are the difficulties implementing their plans?”Organizer team also provided some interventions to solve the problems they faced.<br><b>Results</b><br> In Senegal, actions were not implemented yet, because plans were shared neither with their superintendents nor with Japanese advisors working with trainees as project counterparts. Organizer team set up a meeting with all stakeholders to clarify the objectives and outcomes of the training course within the concept of the project. This process made the superintendents understand and support the action plans, and facilitated to start implementing them. In Benin, trainees started activities by themselves based on their action plan under a small financial support from a Japanese advisor. It was rather easy, because they were decision makers of a hospital, but they faced difficulties to manage the staff to continue the activities. Organizer team encouraged them to continue the activities during the meeting in the hospital.<br><b>Conclusions</b><br> Appropriate participants can be selected and training could be effective, when cooperation project are well defined and the role of advisors is clear in the follow-up. Involvement of decision makers or superintendents for the selection and follow-up process can be a contributing factor to improve the effectiveness of the training.
ABSTRACT
<b>Purpose</b><br> Every year, a lot of training programs by Japan International Cooperation Agency (JICA) are conducted in Japan. However, the method of monitoring and evaluation of those trainings are not always conducted other than simple questionnaire survey. The purpose of this research is to demonstrate the significance of daily recording and analysis of the trainee’s voice as a way of the improvement of the quality of training.<br> Bureau of International Cooperation in National Center for Global Health and Medicine (NCGM) conducted detailed monitoring and evaluation for “JICA training for Maternal and Child Health in French speaking African countries in 2009” which NCGM itself had planned training curriculum and implemented the training. The key word of this training was “Continuum of care”. At the end of the 5 weeks training, NCGM expected the trainees to obtain comprehensive understanding of continuum of care, especially two different perspectives, which were “the health system” and “the dignity of individual client”.<br><b>Method</b><br> NCGM training team kept recording the trainee’s voice, then analyzed them every day during five weeks’ training. At the end of the training course, the team divided trainee’s voice into several categories, and then analyzed their time-dependent change.<br><b>Results</b><br> The everyday recording and analysis of the trainee’s voice made NCGM training team possible to differentiate the trainee’s fundamental interest and understanding from simple guesses or curiosity. Based on the result of daily analysis, the training team could introduce unscheduled discussion or fine-tuned the contents of lectures for better understanding of trainees. The trainees’ interpretation about “continuum of care” showed obvious change before and after the training. The active learning program by using Laboratory method gave deeper impact on trainees than the expectation of training team. At the end of training course, the trainees formulated concrete and detailed action plans. The purpose of their action plans was to establish the continuum of care from aspects of both “the health system” and “the dignity of individual client” by analyzing the existing stakeholders and institutions, and ensuring a collaborative linkage among them, which were exactly the expected outcome.<br><b>Conclusion</b><br> Daily recording and analysis of the trainee’s voice was effective and useful to monitor the training. The comprehensive analysis at the end of training course revealed the short impact of the training on trainees, which could be used as a self evaluation tool for the training team.<br> NCGM plans to visit the trainees’ workplace in their home countries for middle and long term monitoring and evaluation. The results will be feed backed into the training curriculum of next year.
ABSTRACT
There were 651 deliveries and 4 maternal deaths at Christian Hospital Chandraghona between October 2000 and August 2001. Eleven eclampsia patients were admitted and the mean age was 22.1 years. Ten patients were primipara and 1 patient was multipara. Among those eclampsia cases, 2 maternal deaths were observed and 10 patients delivered babies (8 live babies and 2 stillbirths). Delivery methods were 8 normal deliveries, 1 forceps delivery and 1 cesarean section. Ten patients had never consulted a doctor before eclampsia occurred. Eclampsia occurred at the third trimester of pregnancy in 9 patients and after delivery in 2 patients. Nine patients came to the hospital within 5 hours after the onset of eclampsia. Those who came late to the hospital progressed to be maternal death. To reduce maternal death, it is necessary to promote antenatal checkup and provide education about obstetrical complications at the grassroots level.