Bangladesh

Strengthening Bangladesh’s Family Planning Workforce through Competency-Based Training

ihadmin2 — Thu, 02 Mar 2023 15:00:29 +0000

Strengthening Bangladesh’s Family Planning Workforce through Competency-Based Training 2023 ihadmin2 March 02, 2023

This policy brief outlines competency-based training and how it improved family planning training to improve the quality of family planning services in Bangladesh. It discusses Shukhi Jibon project achievements and recommendations to operationalize the expansion of competency-based training in Bangladesh.

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Countries Bangladesh

Projects Accelerating Universal Access to Family Planning (AUAFP)

Topics Family Planning & Reproductive Health Health workforce development

Mahbubur Rashid

kseaton — Tue, 29 Mar 2022 16:13:40 +0000

Mahbubur Rashid Senior technical advisor kseaton March 29, 2022

Mahbubur Rashid is a medical doctor and a public health management professional with over 27 years of experiences including 16 years in leadership and senior management positions in national and international organizations. He is currently serving as the senior technical adviser and leading IntraHealth's team for the Accelerating Universal Access to Family Planning (Shukhi Jibon) project in Bangladesh. He works on maternal, child, and adolescent health and nutrition; family planning; sexual and reproductive health and rights; and women's empowerment. His key expertise includes program and research design, team leadership/management, managing partnerships, situation analysis/needs assessment, strategic planning, policy advocacy, technical writing, proposal development, mentoring, and government and donor relationships.

He was an associate at the Department of International Health, Johns Hopkins Bloomberg School of Public Health and co-authored 33 peer-reviewed journal publications on sexual and reproductive health and maternal and child health.

He has a bachelor of medicine, bachelor of surgery (MBBS) degree, master of science (MSc) degree in epidemiology, Ph.D. in public health, and master's degree in business administration.

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To Improve Family Planning Services, Bangladesh Puts Health Workers at the Center of Training

kseaton — Mon, 28 Mar 2022 16:48:06 +0000

To Improve Family Planning Services, Bangladesh Puts Health Workers at the Center of Training kseaton March 28, 2022

March 30, 2022

How we’re changing approaches in health training centers to increase client satisfaction and service quality.

A little over three years ago, I began hearing about USAID’s Accelerating Universal Access to Family Planning Project in Bangladesh. The project—named Shukhi Jibon, which means “happy life” in Bengali—focuses on developing the family planning workforce and contributes to the health and well-being of Bangladeshis by increasing their use of family planning services.

Shukhi Jibon, I knew, could make a big difference in Bangladesh. For family planning providers, it could help improve health workers’ skills and confidence. For the government and training institutes, the project could improve the quality, efficiency, and performance of family planning services and increase client satisfaction.

Throughout my career, I had worked passionately to improve sexual and reproductive health, family planning, and maternal and child health. If Shukhi Jibon were successful, its benefits would filter beyond family planning to other areas of the health system. So, when the chance to join the project presented itself, I seized the opportunity.

A new approach to training

Family planning in Bangladesh has come a long way, but progress has plateaued in the last decade and regional disparities remain. In response, the government began focusing on universal health coverage, including reproductive health services, and made health workforce development a priority.

Putting health workers at the center of the solution was essential.

Putting health workers at the center of the solution was essential. Happy, satisfied clients are more likely to continue to communicate with their providers and encourage friends and family to seek care as well. But to achieve this kind of multiplier effect in family planning—essentially,

to ensure people who need it most receive the best services and solutions—every health worker must be highly skilled and confident in the services they provide.

Key findings from a training needs assessment we conducted at the beginning of Shukhi Jibon showed us that more than 90% of health facilities in Bangladesh provided family planning services, yet only 57% of clinics had staff who were trained in family planning. Even among those who had been trained, many lacked confidence in their skills. And despite health workers’ obvious skills and confidence gaps, survey respondents also repeatedly questioned the value of trainings. It was apparent that there was a sense of fatigue and perception that the trainings weren’t useful, partly because the trainings were mostly lecture-based and lacked interaction and practicum opportunities.

The Shukhi Jibon way

Shukhi Jibon is led by Pathfinder International, in partnership with lntraHealth International, and in collaboration with the Directorate General for Family Planning, Directorate General of Health Services, and the National Institute of Population Research and Training in the Bangladesh Ministry of Health and Family Welfare.

We knew we needed to change how trainings were conducted and managed.

As collaborators, we knew our solutions needed to address not just the skills and confidence gap, but fundamentally change how trainings were conducted and managed. So we introduced adult learning best practices into curriculum development, trainings, and delivery, and addressed system needs in an efficient, cost-effective way. Some of the approaches and systems we implemented included:

Competency-based training (CBT): a learning-by-doing approach that is interactive, participatory, supports learners, and ensures high-quality practicum training for everyone.
Training management information system (TMIS): a web-based data collection software that helps us administer, document, track, manage, and report on training programs and make data driven decisions.
Optimizing performance and quality (OPQ) approach: IntraHealth’s signature approach for problem solving and capacity building to improve job performance.
Improvement collaboratives (IC): a quality improvement approach that brings people together to improve the quality of training institutes by developing collaborative plans to address gaps in their performance.

And the combined impact of these approaches and tools is making a difference. Trainers who use CBT in their classes report enjoying their sessions more. Trainers and trainees alike are engaged, and trainees better understand training materials.

Managers and heads of training institutes, meanwhile, who previously made decisions ad hoc, are using data from TMIS along with the processes and information derived from OPQ and IC for data-driven decision-making.

We’ve trained trainers from the National Institute of Population Research and Training, Directorate General for Family Planning, Directorate General of Health Services, and other government agencies on CBT and they are now providing training themselves, which has the potential to benefit other types of health worker training.

Shukhi Jibon has also been collaborating closely with other nonprofit partners to ensure cohesion across projects. We supported CBT integration and adult learning into postpartum family planning and maternal and child health trainings led by other nonprofits.

Government officials from the Ministry of Health and Family Welfare, National Institute of Population Research and Training, and Directorate General of Family Planning at a training program. Photo Taken by Mahbubur Rashid for IntraHealth International.

A small group convenes with a trainer to review competency-based training. Photo Taken by Mahbubur Rashid for IntraHealth International.

A training of trainers session on the optimizing performance quality approach and improvement collaboratives. Photo Taken by Mahbubur Rashid for IntraHealth International.

Sessions conducted by a trained trainer on competency-based training. Photo taken by Mahbubur Rashid for IntraHealth International.

High level government officials and trained trainers with the trainers’ manual on competency-based training. Photo taken by Rayan Sharif for IntraHealth International.

Keys to success

In our early days, we really struggled to get people to see and understand the value of CBT and TMIS. Government officials were reluctant to change. To them, what Shukhi Jibon was offering had already been done.

Once we began our training of trainers and demonstrated the impact of CBT approaches, those same government officials started paying attention, some even asking why they didn’t get this kind of training earlier. That’s when we knew we were making progress. After that, in each district we’ve worked, we’ve called on some of these converted officials, and they’ve become our best advocates.

We have always put relationship-building first.

So what’s been central to our success thus far? We have always put relationship-building first. And we prioritize transparency. By our actions and interactions, we’ve slowly won people over.

The future of family planning training in Bangladesh

We’ve laid the groundwork and now it’s time to strive for sustainability and move toward strategy and policymaking. We would like to see our programs included in the next sector plan as well as in the National Institute of Population Research and Training and Directorate General for Family Planning operational plans. Then, the government will own the programs, and we can transfer Shukhi Jibon to the National Institute of Population Research and Training.

Once the Shukhi Jibon project is complete, we will see competency-based training integrated into Bangladesh’s health worker training system and training organizations can start to focus on building trainer techniques. Our dream is that health workers will be able to provide high-quality family planning services and follow standards that will keep their clients coming back.

Accelerating Universal Access to Family Planning is funded by the US Agency for International Development. IntraHealth International is a supporting partner for Pathfinder International.

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Resources

Bangladesh Family Planning Training Needs Assessment: Technical Brief

USAID AUAFP Training Needs Assessment: Final Report

By Mahbubur Rashid

Senior technical advisor

Accelerating Universal Access to Family Planning (AUAFP) Family Planning & Reproductive Health Education & Performance Health workforce development World Health Worker Week Health Workforce & Systems Management and Performance Health Workers Bangladesh

High level government officials and participants at a workshop for improving quality of training. Photo by Rayan Sharif for IntraHealth International.

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Bangladesh Family Planning Training Needs Assessment: Technical Brief

kmelton — Mon, 12 Jul 2021 19:02:51 +0000

Bangladesh Family Planning Training Needs Assessment: Technical Brief 2019 kmelton July 12, 2021 Download

Countries Bangladesh

Projects Accelerating Universal Access to Family Planning (AUAFP)

Topics Family Planning & Reproductive Health

USAID AUAFP Training Needs Assessment: Final Report

kmelton — Mon, 12 Jul 2021 18:58:17 +0000

USAID AUAFP Training Needs Assessment: Final Report 2019 kmelton July 12, 2021 Download

Countries Bangladesh

Projects Accelerating Universal Access to Family Planning (AUAFP)

Topics Family Planning & Reproductive Health

Competency-Based Training Trainer's Manual

kseaton — Mon, 21 Dec 2020 14:00:59 +0000

Competency-Based Training Trainer's Manual 2020 kseaton December 21, 2020

Download

Countries Bangladesh

Projects Accelerating Universal Access to Family Planning (AUAFP)

Topics Family Planning & Reproductive Health Education & Performance

Competency-Based Training Modules 1-4

kseaton — Mon, 21 Dec 2020 13:58:21 +0000

Competency-Based Training Modules 1-4 2020 kseaton December 21, 2020 Download

Countries Bangladesh

Projects Accelerating Universal Access to Family Planning (AUAFP)

Topics Family Planning & Reproductive Health Education & Performance

Competency-Based Training Module 5-11

kseaton — Mon, 21 Dec 2020 13:56:27 +0000

Competency-Based Training Module 5-11 2020 kseaton December 21, 2020 Download

Countries Bangladesh

Projects Accelerating Universal Access to Family Planning (AUAFP)

Topics Family Planning & Reproductive Health Education & Performance

I Am a Midwife in a Rohingya Refugee Camp—Here’s What It’s Like

kseaton — Tue, 05 May 2020 14:43:46 +0000

I Am a Midwife in a Rohingya Refugee Camp—Here’s What It’s Like kseaton May 05, 2020

May 07, 2020

We face many challenges, but one of the biggest is building women’s trust in us.

Within a seven-block area live over 20,000 people. Most live in sheds, and some families are seven to a single room. Children don’t run free in the streets—they are confined to small areas.

These are refugees, living in Rohingya refugee camps.

They have fled their country to escape persecution. But most of them left lives of possession to find themselves inside a fence with nothing but the clothes on their backs and their families. They are anxious, depressed, and suspicious.

The women continue to get pregnant because they do not have knowledge of long-term family planning solutions. I have been a midwife in these camps for the last two years. I am 23 years old.

When I was 10 years old, I watched as my cousin gave birth at home to a stillborn baby. The devastation of that moment, in some ways, inspired me to grow up and help women to have healthy babies.

It is my deepest desire to serve people and provide mothers with the pleasure and happiness of bringing healthy life into this world.

But in the beginning of my time as a midwife inside the camps, it was very difficult to help pregnant women.

Our role as midwives over the last two years has been a job of trust-building.

For one thing, the refugees did not trust us midwives. In their minds, we were too young to know what we were doing. We didn’t speak the same language. Even though we were trained well, most refugees preferred in-home births with traditional birth attendants, who do not have the proper training to deal with the unexpected outcomes of various births.

There was so much mistrust that even when mothers would have facility births, some with postpartum issues would refuse our referrals to a hospital outside the camps, even when we provided ambulance transportation.

Shortly after I started working as a midwife, there was a woman with postpartum hemorrhaging that desperately needed a blood transfusion. But no one in the camp would donate their blood. This woman died in an ambulance.

Our role as midwives over the last two years has been a job of trust-building. When a woman comes into our facility to confirm pregnancy, we try to educate her. We let her know of important prenatal care. Proper nutrition. We reach out to family members to create a network of support to promote a proper birth plans. We identify high-risk pregnancies and create schedules for follow-up appointments. Our primary health care facility is a place to build trust between mothers and health care professionals.

A woman once came into our facility. She was pregnant and had suffered eight miscarriages. She had never received proper care from midwives or professionals.

We established trust and built a relationship that would ensure the health of her and her child. She delivered a healthy baby in our facility.

Over the last two years, the gap between refugees and midwives has gotten smaller. The number of in-facility births is much higher now. Also, women are starting to use long-term family planning solutions, which will reduce numbers of unwanted pregnancies.

A few weeks ago, I delivered a baby who was not breathing. Upon birth, we used our expertise and resources in the facility to help bring breath to that baby. It gives me great pleasure and joy to have the privilege of placing a healthy, newborn baby into the arms of its mother.

I love my work. Thank you.

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