CAPACITY BUILDING IN THE HEALTH SECTOR
In order to sustain the flames of the ongoing revolution in the Health Sector, routine training have become a constant feature in the sector. Not limited to medical personnel and paramedics alone, these trainings have had men and women from diverse professions such as the Nigeria Police Force, LASTMA, Civil Defence Corps, and most recently, journalists benefiting therefrom.
Going by the words of Dr Tunji Olowolafe, the C.E.O Deux Project, a leading consultancy firm that facilitated this exercise for the Lagos State Government, “these trainings are geared at imparting life-saving skills into the average person, with a view to reducing mortality rate arising from emergency situations”. These pictures were taken from the different sessions.
GETTING SET FOR THE MATERNAL AND CHILD CENTRES:
LAGOS STATE TRAINS IN EMERGENCY OBSTETRIC CARE, GOOD LABOUR WARD PRACTICE, AND PRACTICAL OBSTETRICS.
To say that the Maternal and Child Centres about to be commissioned by Lagos State are visionary is putting it mildly. However, what is even more amazing is the planning that has gone into them, particularly pertaining to training of the manpower that will work within them.
Emergency Obstetric Care (EMOC) training is one of the most important interventions proven to reduce maternal mortality (death of women during pregnancy), especially in countries like Nigeria where there is a high death rate in pregnant women. The training and retraining of midwives and doctors in EMOC is thus essential to achieve the 5th Millennium Development goal (reducing maternal mortality by 75% by 2015) and goes a long way towards achieving the 4th Millennium Development Goal (MDG 4 – reducing child mortality by two-thirds by 2015).
In 2008, Lagos State began a unique set of EMOC Courses,
specifically designed in modules during which midwives and
doctors in the state are trained in various types of
emergencies, in good labour ward practice and in practical
life saving manoeuvres which are usually performed in
emergency situations. These courses were all organized,
designed and delivered by Deux Project Limited as
Consultants to Lagos State.
The courses were aimed towards improving the skills of the medical staff of the Lagos State secondary health care centres, that is. the general hospitals spread around the state metropolis. The course content and method of delivery is designed in a way that would suit the target group i.e. midwives and doctors working de from July and August.
The courses were commenced in April 2008 and since their inception they have been conducted every month aside from July and August.
The courses presented by capable hands from Deux Project were presented in an interactive form that encouraged the active participation and contribution of the participants thereby creating a conducive environment that encourages learning and further unfettered practice. Modern teaching aids such as, multimedia PowerPoint presentations with the use of a computer and overhead projector were generously used. Life sized obstetric mannequins were used for demonstrations and the participants were encouraged to work with the various equipment. Paradigms were challenged and shifted and progress was made towards a more progressive form of practice.
So far the course has trained 341 medical personnel 56 of whom are doctors while 285 of them are nurse – midwives drawn from a cross section of 25 general hospitals from across the state metropolis. The feedback from the trainees has been overwhelmingly positive with each one commenting that their knowledge base has been improved and that they have learnt new things. They recommended that the training be extended to the rest of the staff and also for refresher courses on a regular basis.
The training has helped create the awareness for the use of partograph (a simple graphical form of monitoring labour using a char and rulers) and also motivated the staff in some general hospitals in the state to start using the partograph in the monitoring e.g. Gbagada G.H. However this trend has also extended into other areas like the use of misoprostol for post partum haemorrhage, use of magnesium sulphate in eclampsia and severe pre-eclampsia.
Also extended into other areas like the use of misoprostol for post partum haemorrhage, use of magnesium sulphate in eclampsia and severe pre-eclampsia.
Haemorrhage or bleeding from the genital tract is one of the leading causes of maternal death. Infections, rupture of the uterus (womb), specific hypertensive diseases of pregnancy known as pre-eclampsia and eclampsia and abortion are also common causes of death in pregnancy. These topics are taken individually and broken into theory, group discussions, question and answer sessions and practical demonstrations, with the use of state of the art life-size models.
For the Good Labour Ward Practice modules, aspects of pregnancy care such as normal and abnormal labour, induction of labour (when the medical personnel give the pregnant woman drugs to stimulate labour), monitoring of the unborn baby during labour to ensure that it is born in a healthy condition and the appropriate tools to use for this.
Making his comments known on the exercise, the C.E.O. Deux Project said “One running thread in the above two courses is the use of Evidence based medicine which is the most current and internationally accepted way of practising clinical medicine. It entails the knowledge and awareness of the best possible research done on every topic in medicine, combining all that is available on each topic and getting the correct method of treating or operating on a patient. This practice has helped make the practice of medicine, particularly childbirth, more accurate, more cost effective and more efficient.” The availability of technology and the Internet worldwide has also made it possible to find and use this evidence anywhere in the world as long as the practising health workers are aware of its existence. As the EMOC and Good Labour ward practice courses are designed and taught using evidence based medicine, they remain a unique innovation by the state.
The availability of technology and the Internet worldwide
has also made it possible to find and use this evidence
anywhere in the world as long as the practising health
workers are aware of its existence. As the EMOC and Good
Labour ward practice courses are designed and taught using
evidence based medicine, they remain a unique innovation by
Finally, the International Practical Obstetrics course, that was also introduced last year as a form of exposing some of the Lagos State obstetric health workers to the practical manoeuvres used in emergency obstetrics, complete the triad of courses designed for reducing maternal mortality and staffing the maternal and child centres. These courses handled by trusted and tested trainers of Deux Project from the UK are instructors of the renowned ALSO (Advanced Life Support in Obstetrics) course which were expertly delivered with the use of life-sized models. They drill the participants in the practical manoeuvres carried out during normal labour and during emergencies so that these practices can become second nature and can be deployed in actual life-threatening situations. The ALSO course is accredited by the American Academy of Family Physicians, U.S.A.
The ALSO course is accredited by the American Academy of Family Physicians, U.S.A.
This year, even more emphasis has been placed on training staff from the general hospitals in the vicinity of the maternal and child centres (MCC). The first 3 MCCs in Ikorodu, Isolo and Ifako-Ijaiye will be ready for commissioning in a month's time while the remaining three will be ready before the end of the year. These centres are health facilities for pregnant women and their children which incorporate preventive and first contact care (primary health care) and intermediate level curative or hospital care (secondary health care) under one roof. Women can attend these centres from the time when they get pregnant until delivery and during the post-delivery period, and continue to attend after their children are delivered till they become adults. The centres would collectively provide an additional 66% capacity to the available state maternal and child specialist facilities. The catchment population to be serviced by these facilities are Ikorodu (1.4M), Ifako-Ijaiye (919,9000), Isolo (1.33M), Gbaja-Surulere (1.08M), Amuwo-Odofin (684,000), Ajeromi (1.47M) and Ibeju-Lekki (620,0000).The local people in these areas will be the clients at these centres and the aim is to take pressure off the current big central hospitals.
The centres would collectively provide an additional 66% capacity to the available state maternal and child specialist facilities. The catchment population to be serviced by these facilities are Ikorodu (1.4M), Ifako-Ijaiye (919,9000), Isolo (1.33M), Gbaja-Surulere (1.08M), Amuwo-Odofin (684,000), Ajeromi (1.47M) and Ibeju-Lekki (620,0000).The local people in these areas will be the clients at these centres and the aim is to take pressure off the current big central hospitals.
Thus Lagos State is comprehensively prepared to achieve the 4th and 5th MDGs by building the infrastructure i.e. the MCCs as well as providing the appropriate manpower training that is often lacking in our environment, well ahead of the opening of the centres. This is to give kudos to the vision of the Government of His Excellency Governor Babatunde Raji Fashola.