Page 102 - GHES-2-4

Global Health Economics and
Sustainability
Sustainable, competent health trainers

and avoiding harmful practices that were previously their groups, ask them to interact with mothers
followed without assessing their clinical relevance or of admitted children here, conduct a diet audit,
checking if the practice had an evidence base. and make them think about possible reasons

“Due to this training, not only me but also my for malnutrition among children. I understood
ANMs started following the DR-ABC approach how I could involve the students and engage
them in learning.” (Palghar MT [MO, Nutrition
very diligently and not missing out on important Rehabilitation Center, SDH], who manages
investigations such as measuring respiratory rate.” medical college students interning at their
(Palghar MT [CHO]) hospital)
“We were copying our seniors and giving fundal
pressure when the baby would be stuck; or rupture 3.3.3. Career growth- recognition and motivation
the membrane artificially. I learned about the Apart from the direct benefits to the Palghar MTs in terms
consequences of such practices and have stopped of increased clinical competency and confidence as trainers,
doing them. I have even told the same to my the training intervention additionally benefitted them in
colleagues.” (Palghar MT [staff nurse, RH]) receiving recognition or appreciation from colleagues
“Recently, I have received one referral from a PHC. The and superiors and added value to their leadership roles
child had pneumonia and was in respiratory distress. in their health facilities. They expressed their willingness
The case was not manageable by the PHC staff. They to continue working as trainers in the future and even
referred the child to our facility but with oxygen. So get promoted to CT. Receiving critical feedback as well as
we could start higher treatment immediately.” (Palghar appreciation from the UK experts during the live virtual
MT [MO, SDH]) quality assessment sessions was a motivating moment for
“Even when I want to refer a case to a higher the Palghar MTs.
hospital, I don’t hesitate to call the specialist and
describe the case as per the SBAR taught to us “My image as a medical officer has changed. Even
during this training.” (Palghar MT [MO, RH]) other PHC doctors call me or discuss with me any
clinical problem because they all know that I work
3.3.2. Confidence as a trainer as this project’s trainer. The problem gets solved by
sharing, so it benefits.” (Palghar MT [MO-PHC])
Building the confidence of trainers was another focus area
of this intervention. Palghar MTs were involved in repeated “The enthusiasm of the trainers (Palghar MTs)
is worth noting, especially moving forward as a
training sessions for health providers. This resulted in group in these challenging years (of the COVID
more opportunities for peer interactions, encouragement pandemic).” (UK expert)
from Pune CTs and UK experts, and increased confidence. “After receiving this training, even my senior sir asked
With experience working as MTs in the project, they for my clinical opinion. I feel good that my knowledge
started applying the newly learned adult learner training is being useful.” (Palghar MT [MO-RH])
pedagogy in their own health facilities, as well as in other “I feel so motivated. Even I would like to work like
settings and training programs. The following quotes Pune CT and travel to other places to train more
explain the nuances of increased confidence mentioned by trainers.” (Palghar MT [MO-PHC])
the Palghar MTs:
“I wanted to overcome my stage fright; hence, so 4. Discussion
I participated as a trainer in a number of batches The MNH-related skill deficits and the urgent need to
during this project. I learned many new things, strengthen the health workforce are evident in several
such as how to present a topic or how to organize studies (Iyengar & Iyengar, 2009; Nandan & Agarwal,
a training program. I now feel very confident.” 2012; Rao et al., 2019; Karvande et al., 2020; Privitera
(Palghar MT [MO-PHC]) 2021; Karan et al., 2021). The low pre-training assessment
“I am sharing my knowledge on case management scores of health providers from Palghar confirmed
with my colleagues who could not attend this these deficits. Recent initiatives in India, such as skills
training. That’s a wonderful feeling, which also laboratories, Dakshata training (Chhugani, 2015), and
increases our own knowledge.” (Palghar MT [staff India’s National Training Strategy (National Training
nurse, SDH]) Strategy for the Ministry of Health and Family Welfare,
“Earlier, my ‘teaching pattern’ was just to talk Government of India, 2008), have shifted focus to skills-
and talk and give information to students who based training strategies. However, the benefits of these
would come and learn nutrition here. I now make strategies have yet to reach frontline health workers

Volume 2 Issue 4 (2024) 7 https://doi.org/10.36922/ghes.2963