Strengthening new-born health workforce in Chhattisgarh by tele-mentoring

UNICEF partnered with Equalize Health, a nonprofit medical technology company, to sharpen the skills of nurses and strengthen SNCUs across the state

UNICEF
Prabha Ratre, a nurse in Special Newborn Care Unit (SNCU) in district hospital of Mahasamund in Chhattisgarh, India.
UNICEF
27 May 2022

CHHATTISGARH, India - “Nursing is one of the fine arts, the finest of fine arts,” said Florence Nightingale, founder of modern nursing. Nurses remain the backbone of human resources in health and help save lives.

“I am glad that I am a nurse today. It is so satisfying to know and understand the concerns and challenges of my patients (babies) and their parents," says Prabha Ratre, a nurse in the Special Newborn Care Unit (SNCU) in the district hospital of Mahasamund in Chhattisgarh, India. Nurses like Prabha have been crucial in saving the lives of many newborns in SNCUs across the country. So far, the Government of Chhattisgarh in India has set up 25 SNCUs in 24 districts.

Recognizing the critical role of the nursing cadre in reducing neonatal mortality and improving health outcomes, the government has prioritized the placement, skilling, and strengthening capacities of nurses in SNCUs. Investing in nurses like Prabha is crucial to achieving newborn health outcomes. 

Leveraging Technology to Respond to Local Needs

UNICEF partnered with Equalize Health, a nonprofit medical technology company, to sharpen the skills of nurses and strengthen SNCUs across the state. Equalize Health, like UNICEF, shares the common goal of equitable access to quality medical care and conducted a study to understand the need for a tele-mentoring programme. The study results indicated that nursing staff, often overburdened, need support to enhance capacities and confidence to tackle emergency medical situations and the general management of cases in the SNCU. With support from the Government of Chhattisgarh, UNICEF and Equalize Health developed the TECNeC (Training for Enhancing Capacities in Neonatal Care) capacity building programme at scale across all SNCUs in the state.

Since one-to-one consultation and in-person training for all nurses is near impossible to deliver in many remote areas using traditional means, we used the innovative ECHO tele-mentoring model. This model, combined with Equalize Health’s results-based approach, focuses on reaching as many nurses as possible and improving health outcomes for many newborn babies.

Regularly scheduled, curriculum-based tele-mentoring sessions brought together expert neonatal specialists from across the country. Nurses participating in the programme benefited from the growth of knowledge networks, communities of practice, and the ongoing encouragement of case-based discussions. 
Online training sessions are conducted once a week. The pedagogy includes a lecture by the expert, a case presentation by nurses, and a question and answers session. WhatsApp focus groups ensure continued touchpoints between the nurses and experts. The nurses utilize the WhatsApp group to ask real-time case-based questions to the experts.

A live programme dashboard for publishing session recordings, attendance, quiz scores, and champion nurses of the week is also included in the digital training series. 

 

Prabha Ratre, a nurse in Special Newborn Care Unit (SNCU) in district hospital of Mahasamund in Chhattisgarh, India.
UNICEF

A baseline assessment at the start of every session followed by additional assessments up to six months upon completion of the programme will highlight the impact this support will have on nursing care for newborn patients in SNCUs. Completion certificates to all nurses who have 70% attendance - also help build confidence and recognition for nursing staff who have endured many pressures over the last 12-18 months.

The programme helps address many challenges like nurses’ inability to use the online training platform, being underconfident to voice concerns to superiors and seniors, and presenting cases in front of a large audience. The one-to-one counselling-built confidence increased staff morale and higher efficiency.

Since January 2021, more than 100 nurses from 25 SNCUs have been part of the programme. Two hundred more nurses are enthusiastic and eager to be part of the programme and trained soon.

The below testimonials from a few trained nurses highlight the transformational change coming about in practices and processes in the SNCUs.

“I have received training for the first time. I got the opportunity to learn a lot through this training. I am more confident in providing treatment to the patients now. I have learned to adapt and clinically respond depending on the condition of the patient,” says Nurse Purnima Baghel, SNCU Sukma.

“I learned regarding the improvements to be made in our SNCU to save the babies from sepsis. I learned how to bring KMC, breastfeeding techniques, fluid, and medicine dose management into our day-to-day practice. Now I can also manage babies in convulsion. I gained a lot of knowledge through TECNeC. The entire team feels like a family now. I want to thank the TECNeC team members for organizing this training” say Nurse Nidhi Sahu, SNCU Kondagaon.

“We could change the way we administered injection in bolus. We now change the humidifier and suction machine in every shift. We now pay close attention to the APGAR. I learned how to operate a CPAP machine and prevent nasal injury. The training has been helpful.” Nurse Saroj Sahu, SNCU Mahasamund.

Inputs from Lakshmi Nair, Akansha Singh, Dr. Sridhar Ryavanki, Dr. Atul Jindal, Dr. Gajendra Singh, Job Zacharia