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Nigeria, Africa’s most populous country with a population of over 180 million people, is ranked the second largest contributor to the under–five mortality rate in the world and the largest contributor in Africa. Nigeria’s newborn death rate (neonatal mortality) is put at 528 newborn deaths per day (one of the highest in the world). More than a quarter of the estimated 1 million children who die under the age of 5 years annually in Nigeria die during the first 28 days of life (neonatal period).
The majority of these deaths are caused by conditions that are preventable or treatable. In fact, 9 of every 10 new-born deaths are preventable. While some progress has been made to reduce these deaths over the past decade, the rate of change is not fast enough for Nigeria to meet the Sustainable Development Goals.
Key interventions and packages that could prevent 70% of new-born deaths in Nigeria exist, but coverage is low. The policies are in place; however action is needed at state and local levels to increase coverage and quality of life-saving interventions while closing the equity gap for the poorest families.
Save the Children, through the Health workers’ capacity building project, is committed to improving quality Maternal, New-born and child health services through capacity building of frontline health workers and advocating to influence policy changes related to MNCH indices.
Essential New-born Care
Essential Newborn Care (ENC) is care that every newborn baby needs regardless of where it is born or its size. ENC should be applied immediately after the baby is born and continued for at least the first 7 days after birth. Many ENC interventions are simple and can be provided by a Skilled Birth Attendant (SBA) or a trained Community Health Worker (CHW).
Essential newborn care includes:
Early initiation and exclusive breastfeeding;
Thermal care (including prompt drying and covering at birth, maximizing skin-to-skin contact, delayed bathing, maintaining “warm chain”);
Hygiene practices (including cord-care and hand washing).
There is good evidence that adherence to recommended essential newborn care practices substantially reduces mortality risk, especially for very small newborns.
Nigeria in 2008 adopted the WHO Essential Newborn Care Course package. In adapting the generic course to the country, it has undergone several adaptations and updates. The training package is aimed towards the acceleration of progress towards achieving significant reduction in infant and Under-five mortality.
Purpose of the Training
The goal of this training is to improve the skills of 50 select frontline health workers (Doctors/Nurses/Midwives) from secondary health facilities in Kaduna state on Essential New-born Care package using standard national training guidelines.
Build the capacity of 50 Health workers on the concept of Helping Babies Breathe (HBB);
Improve the skills of the trainees on routine cares of all babies (ECEB);
Improve knowledge and skills of health workers on essential care for small babies (ECSB);
Improve knowledge of health workers on referrals of babies identified to be in severe situation that requires referral.
Approach & Methodology
An ENCC objective-structured clinical assessment checklist will be used in the conduct of a Training Needs Assessment. All the secondary health facilities would be visited and the assessment checklist administered to assess the skills gap observed. The gaps observed would be used in the design of the training intervention. The TNA would be conducted in 3 zones in Kaduna over a period of 5 days;
The training will be led by a Lead Consultant along with 4 other resource persons (including the MNCH Advisor);
Training slides and manuals would be drawn from FMOH approved guidelines for ENCC;
The training will involve the use of low technology and highly effective teaching methods: simulation, role play, drills, skills practice and practical demonstration amongst others;
The training will also be conducted using mannequins for practice;
The training would be a combination of both classroom and practical sessions with participants scheduled to visit selected hospitals for the practical sessions;
Pre-test and Post-test evaluation would be used in assessing knowledge gained by trainees;
The consultant/facilitators would conduct a post-training follow-up and supportive supervision to facilities where selected health workers have been trained within 6-8 weeks of the training.
Review of the current FMoH ENCC course guide and materials for training health providers in order to ensure the incorporation of new-born care component (first week of life);
Review current facilitator guide for ENCC and adapt accordingly
Advise Save the Children on the selection criteria of participants to be trained;
Plan and conduct a 4-day ENCC course for the participants from Kaduna. This will include conduct of pre and post-tests;
Identify with help of MNCH Advisor and /State Focal person for ENCC appropriate practicum sites for the ENCC training;
Prepare a follow up plan of the service providers for ENCC that would have been trained;
Conduct post training follow up visits to trained health workers at their respective places of work;
Debrief meeting with project team in Kaduna;
Prepare and submit a report of the training not later than 14 days after the completion of the activity.
Analyses of pre and post-tests results of trained Health workers;
A comprehensive report of the training (both the class room training and the post training follow-up visits).
The required consultant should be an experienced paediatrician (a fellow of West African Medical College/NPMCN) or with a minimum of 5 years’ post-fellowship experience;
He or she should have undertaken a TOT in ENCC;
He or she should be able to mobilize 3 other facilitators (Doctors/Midwives) who have a minimum of 5 years’ experience and have also undertaken a TOT in ENCC training);
He/she should have expertise in Essential New-born care training and programming;
Experienced facilitators of training.