Exploring outcomes: A study on the impact of gynecologist-trained Nurses & birth attendants mentoring women medical officers in natural vaginal birth management in rural setting

Abstract

Background: The relentless endeavor to enhance maternal and neonatal outcomes, especially in resource-limited rural settings, persists as a significant concern in global health. The pivotal role of efficiently managing natural vaginal births – commonly encountered in peripheral healthcare setups – demands an integrated, skilled approach. Tailoring an effective training program, which encompasses a skill transfer from seasoned nurses and birth attendants to WMOs, thus becomes imperative.

Objective: This research aimed to investigate the outcomes and experiences resultant from a gynecologist-designed training model, wherein experienced nurses, and birth attendants (previously mentored by gynecologists) serve as facilitators in enhancing the practical skills of WMOs, primarily focusing on managing natural vaginal births in rural health centers.

Methodology: A mixed method research design was utilized to explore the experiences and perceived impacts of the implemented training model. WMOs, trained nurses, and birth attendants across selected rural centers were enrolled following the implementation of the training model. Data collection was achieved through in-depth interviews and focus group discussions, ensuring a comprehensive exploration of their lived experiences, perceived confidence, skill enhancement, and the perceived impact on maternal and neonatal outcomes. Thematic analysis was employed to distil emerging themes and patterns from the rich, narrative data, ensuring a nuanced understanding of the practical impacts of the training model.

Results: The emergent themes coalesced around the empowerment of WMOs, enhanced confidence in managing vaginal births, practical skill augmentation, and the perceived impact on maternal and neonatal health. Notably, WMOs expressed a marked improvement in their practical skillsets and a bolstered self-assurance in managing births efficiently. Furthermore, narratives illuminated an enriched collegial relationship between WMOs, nurses, and birth attendants, establishing a symbiotic learning environment. Challenges, such as initial resistance and adaptation hurdles, were also elucidated, providing a holistic overview of the experiences post-implementation of the training model.

Conclusion: This study underscores the potential efficacy of a cascade training model, where the expertise of gynecologists permeates through to WMOs via intermediatory training by experienced nurses and birth attendants. The enriched skillset and heightened confidence of WMOs in managing natural vaginal births, juxtaposed with the challenges encountered, proffers invaluable insights for refining and scaling such training models, potentially mitigating the gap of specialized care in rural settings, and enhancing birth outcomes.