RESUMEN
Successive Indian governments have attempted to increase the growth in employment alongside encouraging skill enhancement. Against this background, we empirically explore issues surrounding the investment in specific capital by workers. In particular, we try to discern the presence of specific human capital investment by investigating whether there is a link between tenure and wages and find that there is indeed such a link evident in India. This allows us to infer that it is valuable to have long-term relations between employers and their workers and therefore labour market institutions that support long-term employer-employee relationship need to be encouraged.
RESUMEN
BACKGROUND: The developing world has a significantly high risk of women and babies dying during childbirth. Interprofessional simulation training has improved birth practices and outcomes by impacting clinical and non-technical skills like communication, teamwork, leadership and effective use of resources. While these programs have become a training requirement in many high-income countries, they have not been widely introduced in the low-income, low-resource settings. QUESTION: To explore the use of a structured obstetric and neonatal emergency simulation training program in India. AIM: The aim was to identify the challenges faced by birthing staff in their clinical practice and the key messages learnt from the simulation programs that are applicable to their clinical practices. METHODS: Mobile interprofessional obstetric and neonatal workshops were piloted in three locations (metropolitan, primary rural and secondary hospitals) of India for medical and midwifery staff, and students. Using a pre-post workshop survey design, participants were asked to describe their role and challenges in their birth practice and the key learning acquired by the program. FINDINGS: Eight workshops were conducted across three sites involving a total of 150 participants. Participants at all sites described maintaining safety of women and babies as their key role. Their main challenge was lack of availability of medical back up, resources, structured training and poor compliance from women. The key learning was gaining knowledge and procedural skills, non-technical skills, a systematic approach to obstetric and neonatal emergencies and learning in teams through simulation. IMPLICATIONS FOR PRACTICE: Mobile obstetric and neonatal simulation training workshops were useful for medical and midwifery staff, and students in different health settings in India and may have a role as a routine training tool for health professionals involved in childbirth.