clinical skills training

The Integrated Infectious Diseases Capacity Building Evaluation designed two interventions for mid-level practitioners from 36 primary care facilities in Uganda: the Integrated Management of Infectious Disease (IMID) training program and On-Site Support (OSS). We evaluated their effects on 23 facility performance indicators, including malaria case management.The combination of IMID and OSS was associated with statistically significant improvements in malaria case management.

The shortage of skilled birth attendants has been a key factor in the high maternal and newborn mortality in Afghanistan. Efforts to strengthen pre-service midwifery education in Afghanistan have increased the number of midwives from 467 in 2002 to 2954 in 2010. We analyzed the costs and graduate performance outcomes of the two types of pre-service midwifery education programs in Afghanistan that were either established or strengthened between 2002 and 2010 to guide future program implementation and share lessons learned. CME graduates achieved an overall mean competency score of 63.2% on the clinical competency assessment, compared to 57.3% for IHS graduates. Reproductive health activities accounted for 76% of midwives' time over an average of three months. Approximately 1% of childbirths required referral or resulted in maternal death. On the basis of known costs for the programs, the estimated cost of graduating a class with 25 students averaged US$298,939, or US$10,784 per graduate.

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