HEALTH WORKER TALES: A refresher in-service training that rejuvenated a midwife
If you didn’t know how to drive a car the first time you stepped into it, would it be safe to be on the roads? If nobody taught you how to swim properly, would you be confident to be in the ocean? If you are trying to improve your golf game by “tweaking” your swing plane having no idea where the club is positioned for your body type and build, do you think you will see improvements?
It is these beautifully thought out rhetorical questions that Brian Ondrako poses in trying to decipher the latter part of the quote “Knowledge without Practice is useless, Practice without knowledge is dangerous.”
Similarly, in the context of childbirth, writes Kakaire Ayub Kirunda, it would be risky for a health worker to deliver a mother without knowing how to resuscitate a newborn, in case of an emergency. That is the inference from a conversation with Jinja based midwife Zaina Mutesi who is a beneficiary of a recent training organised under our MANeSCALE project, and targeted medics from below hospital level facilities in select East Central Uganda districts.
“Basing on the knowledge I now have now, there are some babies I look at these days and say to myself that ‘if I had not attended that refresher training, this baby would probably have died because I lacked the required skills,’” says Mutesi who graduated as a midwife 23 years ago. “Nowadays even in theatre, I try my level best to revive those babies that are nearly passing on, save for those whose day has come. My confidence is now built, and I have observed a marked difference in the way I used handle fragile babies.”
Ms Mutesi (above) says that now during every delivery she has conditioned her brain to prepare for “action” in case a newborn requires emergency help. “So, I am always on standby and ready to take action. I don’t have to wait for the baby to come and then start running around. And as we speak now my gadgets are ready.”
The most common emergency for newborn babies is too little oxygen to the baby during childbirth. And when this goes on for too long the attending health worker must help the baby to breath and in some cases restore the baby’s heart rate back to normal. None-the-less, this requires the requisite skills, hence the need for the appropriate training. Without these skills, newborns can be harmed in the process.
As health facility deliveries go up in countries such as Uganda, stories such as Midwife Mutesi’s underscore the need to pay attention to the providers of care if the universal vision to cut preventable maternal and newborn illness and deaths, and to improve every mother’s experience of care is to be realised.
Drawing on Mutesi’s context, the staff shortages, and the so many trainee nurses and midwives from the many mushrooming training schools that have turned into extra pairs of hands on many maternity wards across the country, in service continuous clinical mentorship and refresher trainings will be critical, if preventable newborn deaths are to be capped in hospital settings.