Effect of Skill Birth Attendant Training to Improve the Competency of Service Providers

Study Overview
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Brief Summary
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This clinical trial's primary goal is to compare birth attendants' competencies. It aims to answer the questions: Does the new modular training package enhance the competencies of skilled birth attendants? Does the competencies of skilled birth attendants relates to improving maternal and neonatal health outcomes in Nepal? Is this training module a cost-effective intervention? Participants' knowledge, attitude, and skills will be assessed and it will be compared with standard training groups: Researchers will compare the competencies of birth attendants who receive modular training versus standard training to see if an increment in competencies is associated with maternal and neonatal health outcomes.

Official Title
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Effectiveness of Modular Skilled Birth Attendant Training to Improve the Competencies of Service Providers and Maternal Newborn Health in Nepal: A Randomized Control Pilot Trial

Conditions
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Competencies of Midwives, Cost-benefit Analysis of Modular Training

Intervention / Treatment
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* Behavioral: Skill birth attendant training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Health workers should be Auxiliary Nurse Midwives and Nurses working in birthing centers where at least 10 birth managed in the last year Health workers (Auxiliary Nurse Midwives and Nurses) who are committed to providing maternal and neonatal health services and priority for permanent service holders. Who passes at least the first module (Online module) to participate in modular training Exclusion Criteria: Health workers (Auxiliary Nurse Midwives ad Nurses) who do not provide maternal and neonatal health service Health workers other than Auxiliary Nurse Midwives and Nurses though they provide maternal neonatal health services in government health facilities Health workers working in private health facilities

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The competencies of skilled birth attendants who receive modular training will be compared with those of skilled birth attendants who receive existing standard training.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Skill birth attendants who trained on new modular training package<br>Maternal and child health service providers (skilled birth attendants) will be trained using modular training that covers both theory and practical sessions on midwifery skills. Auxiliary nurse midwives should complete modules 1, 2, and 3 whereas nurses will get modules 1, 2, 3, and 4. The training will be implemented in National Health Training Center-accredited training sites/ hospitals. | Behavioral: Skill birth attendant training<br>* It is an intervention targeted to enhance the competencies of Maternal Neonatal Health (MNH) service providers (skilled birth attendants) in Nepal. It is a capacity-building intervention that is expected to contribute to reducing maternal and neonatal morbidities and mortalities by improving the midwifery competencies (knowledge, attitudes, and skills) of MNH service providers.<br>|
| Active Comparator: Skill birth attendants who trained on existing standard training package<br>Maternal and child health service providers (auxiliary nurse midwives and nurses) get training based on the existing standard skilled birth attendant training curriculum of Nepal. This is a two-month-long integrated skill birth attendant package implemented in National Health Training Center-accredited training sites. The midwifery competencies of these service providers will be assessed and compared with the competencies of experimental groups. | Behavioral: Skill birth attendant training<br>* It is an intervention targeted to enhance the competencies of Maternal Neonatal Health (MNH) service providers (skilled birth attendants) in Nepal. It is a capacity-building intervention that is expected to contribute to reducing maternal and neonatal morbidities and mortalities by improving the midwifery competencies (knowledge, attitudes, and skills) of MNH service providers.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effectiveness assessment of modular skilled birth attendant training package | The health workers who get new modular skill birth attendant training are expected to be more competent to provide midwifery services. Hence, this training is specifically targeted to improve midwifery knowledge, attitudes, and skills. | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cost-benefit analysis | The associated cost (monetary value) of the new modular and standard training will be calculated and compared with the effect (maternal and neonatal death reduction). | 2 years |