Training the Trainers – The Next Step in Newborn Healthcare
Saving Babies Lives (SBL) is AHC’s flagship programme, charged with improving the neonatal mortality rate in one of the most rural Cambodia’s provinces, Preah Vihear. The SBL team have been on the ground in Preah Vihear for two years, having already trained hundreds of government healthcare workers across the province in effective newborn healthcare. Now, the next step is ensuring sustainability by scaling education: training local key staff to become trainers themselves.
Dr. Sopheak Neary Say is the SBL Referral Hospital Lead and oversees the mentorship of Preah Vihear Referral Hospital staff. Dr. Neary has been working at AHC for six years, having graduated from AHC’s three-year medical residency programme before making the decision to join the Global Child Health Department and SBL team.
“I first joined the SBL team because I know how important basic interventions and training is when treating a sick newborn. The SBL programme was teaching life-saving skills to local staff who could then share those skills for many years to come.” Dr. Sopheak Neary Say
When Dr. Neary and the SBL team made their initial visit to Preah Vihear they were immediately confronted with the reality of healthcare in the province, the remoteness of the villages, the conditions at the healthcare facilities, and the limitation of knowledge on neonatal care of local healthcare staff.
“The first thing we noticed was the lack of confidence the staff had when treating a neonate. They approached treatment of a one-week-old newborn the same as they would a 10-year-old child. Some couldn’t even perform basic resuscitation treatment, which was obviously very concerning.” Dr. Sopheak Neary Say
Today, because of SBL’s interventions, the Referral Hospital has transformed into a model of neonatal care in the province. Dr. Neary and the SBL team have trained the Referral Hospital staff how to care for newborns, including Neonatal Resuscitation Training and a ToT (Training of Trainers) sessions. The SBL team were a constant presence at the newly established Neonatal Unit within the hospital; mentoring staff, managing the operation of the unit, and training staff on how to operate the new, lifesaving equipment provided as part of the SBL programme to the Referral Hospital.
Eight trainers were selected from the Referral Hospital for the ToT programme including three doctors, three nurses, and two midwives. Sinoun, a nurse from the Preah Vihear Referral Hospital, was one of the eight selected to be a trainer. She joined the SBL programme four months late and began with no knowledge of how to treat a neonate. Sinoun struggled for the initial month working in the new Neonatal Unit. But through the training and mentorship of Dr. Neary, she developed proficiency in neonatal care, and showed positive signs of leadership.
“Today, Sinoun can lead a case, care for a sick newborn, and is always keeping me up to date with what is happening at the hospital when I am not there. She is a great example of what the ToT training can achieve.” Dr. Sopheak Neary Say
Recently, Sinoun and the team were put into an emergency situation when a premature baby born at the hospital’s delivery room was transferred to its Neonatal Unit. The neonate weighed only 1.1kgs and was in critical condition, barely breathing. Sinoun and the team immediately went to action, successfully performing emergency neonatal resuscitation. The baby was given specialised care and recovered fully from its premature complications, with Sinoun providing daily feedback to the SBL team. The Referral Hospital staff were able to care for a critically ill newborn and apply the skills they had learnt, without requiring assistance from the SBL team.
“I was so impressed with Sinoun, and the whole Preah Vihear Referral Hospital team, who cared for this patient. For them to perform all of the correct procedures and save this baby’s life, without any help from me or the SBL team, was a huge success for the Referral Hospital team. It showed them they were not students anymore, but teachers of neonatal healthcare.” Dr. Sopheak Neary Say
The next phase for Referral Hospital staff is to manage the Neonatal Unit independently. This includes maintaining and fixing the equipment, organising medical inventory, and most notably, managing the constant staff shortages at the hospital. In the coming months Dr. Neary and the SBL team plan to reduce their visits from fortnightly to only once per month.
“There is still plenty of work to be done at the Referral Hospital. The trainers need to continue leading resuscitation training sessions and simulations. But I am so proud of how far the team have come. Their hard work and commitment is the reason newborn babies’ lives are being saved today in Preah Vihear.” Dr. Sopheak Neary Say