USAID Integrated Health Program- Facility based Clinical Skills training using Low Dose High Frequency Capacity Building Approach Kebbi State

In recognition of ARFH technical competency in Capacity building of Healthcare workers on the Facility-based Clinical Skills training using Low Dose High Frequency (LDHF) for health care providers in 122 Primary Health Care Centres(PHCs) (1 per ward) covering Postpartum Family Planning (PPFP), Long Acting Reversible Contraceptives (LARC) & Depot Medroxylprogesterone Acetate-Subcutaneous (DMPA-SC) Injectable in Kebbi state with support from “USAID Integrated Health Program”.

ARFH is currently one of the Grantees of the Palladium/USAID Integrated Health Program. This is an onsite, competency-based, sequenced training and learning approach. The learning activities concentrate on what providers “need to know,” thus eliminating what is “nice to know.” It utilizes interactive, practice-heavy techniques (such as clinical simulation, case-based learning, hands-on practice with anatomic models, and immediate feedback on performance) in low (small) doses of targeted learning contents not lasting more than 2-3 hours in one day, which are appropriately spaced over a specified period.

The training is team-focused ensuring that all providers have updated clinical practice and can work together to implement improvements in care. Being a facility-based training approach, it decreases absenteeism, improves teamwork, addresses onsite barriers, and promotes changes to provider performance. This facility-based training is followed by ongoing, structured follow-up led by Peer Practice Coordinators (PPCs) and supported by mobile mentors.

The PPCs are resident service providers selected based on demonstrated interest and motivation to lead the training process. The trainees also received structured, monthly half-hour mentoring calls from a trainer/master mentor in order to provide remote support. Our achievements  in the 11 LGAs (B/Kebbi, Gwandu, Arewa, Suru, Koko/Besse, Shanga, Fakai, Maiyama, Bagudo, Zuru and Sakaba/Danko-Wasagu) of Kebbi state in the last five months.

1. Availability of 4 qualified providers per facility, 488 Health care workers trained to date to deliver quality FP services including DMPA-SC and Emergency Contraceptives for GBV Survivors in 94 health facilities Successfully set-up of quality Family Planning Procedure Room with supply of Consumables, Global FP Handbook for Providers (2018 Edition) to serve as reference points and all necessary equipment by IHP in all project facilities where they were not existing
2. Integrated Supportive Supervision to promote quality service delivery is currently on-going
3. Reinforcement of COVID-19 Preventive measures including creation of handwashing spaces with appropriate posters pasted in conspicuous locations to facilitate adherence
4. Provision of models and Job Aids including Training and Participants Manuals to enhance knowledge through continuous mentoring and practice among trained providers
5. Whole-Site Orientation conducted in all project facilities involving all units in the facilities, community leaders, and key stakeholders aimed at ensuring effective dissemination of FP information within the facilities and communities as well as environments
6. Active involvement of all stakeholders including WDC, Traditional Rulers as Advocates of Family Planning, thus leading to increased uptake of FP services and dispelling of myths and misconceptions against FP services vii. Successful engagement of Males Advocates To achieve a total saturation and high impact in the state, the project is currently the process of expanding to the remaining Local Government Areas

Efficient system of commodity supply and resupply through the state and LGA FP Coordinators:

On the UNFPA supported project, ARFH is supporting state Government to avert the problems of artificial stock out, Mal-distribution of FP commodities. This ensured seamless operations, keying into the regular state and LGA CLMS. DMPA-SC injection was routed through the CBO to the state to ensure accountability. The CBO were responsible for the resupply of the MBHA while the states took care of the supply to PHCs.

• Supportive Supervision & OJT -Trained CHEWs on the LARC project were also co-opted into the project to support continuing monitoring and to also serve as focal persons in referral facilities. This allowed prompt attendance to referred clients in proximal health facilities.
• Monitoring & Data quality Assurance activities – Monitoring and Data Collection by CHEW Preceptors in Kebbi, Gombe and Ebonyi states in which ARFH-trained state trainers were commissioned to continue the quarterly supervision and data collection from facilities where the project has trained CHEWs. Data collection tools were produced the same week funds were released and deployed to the states.
• Monthly meeting between the MBHAs and CBVHWs were held to promote quality of care and to ensure information concerning clients is recorded in the National FP register.

Mobile Family planning initiative – Wellness on Wheels

As part of our contributions towards increasing contraceptive uptake, ARFH introduced and implemented a mobile family planning service delivery initiative using “KEKE ARFH” (Tricycle) in selected communities and markets in 2 LGAs in Ibadan – Ibadan North and Ibadan North East).

The success of this initiative is due to ARFH’s partnership with Association of Community Birth Attendants (ACOMBA), National Union of Road Transport Workers (NURTW), market men and women and community/religious leaders in both locations.

A remarkable achievement of this innovative approach was the increase in FP clientele significantly by over 60% in Ibadan.

The project has been expanded to FCT

Facility based Clinical Skills training using Low Dose High Frequency Capacity Building Approach  FCT

Goal:

To build the capacity of frontline healthcare workers at primary health care facilities to provide age and gender-sensitive, high quality family planning and reproductive health services in FCT by December 31, 2021 starting from August 1st, 2021.

Objectives:

1. a) To update a team of health workers at primary health care centers and private health facilities on knowledge and standardize clinical skills to provide Long Acting Reversible Contraceptives, Depot Medroxyprogesterone Acetate-Sub-cutaneous and Postpartum Family Planning (LARC, DMPA-SC & PPFP).
2. b) To improve in a positive way, the attitudes of service providers towards provision of voluntary family planning, including PPFP, LARC (Interval & Postpartum) & DMPA SC.
3. c) To Introduce the concept of GESI/GBV and Integrate adolescent and youth friendly services into PHC facilities
4. d) To expand the contraceptive mix available in the supported primary health facilities and private health facilities.
5. e) To strengthen the capacity of the health workers at primary health care centers and private health facilities on correct and appropriate documentation of service delivery and commodity management and data use for improved services and decision making.
6. f) Provide post-training supportive supervision and mentoring to reinforce knowledge and skills