1. Planning for implementation Name of presenter Prevention of Postpartum Hemorrhage Initiative (POPPHI) Project PATH

2. Objectives After completing this session, the participant will be able to Complete the Training Logbook Develop a training strategy for her/his facility Assist learners with developing a plan for completing the AMTSL course Monitor progress towards achieving 100% coverage for AMTSL 10-1

3. Keeping track of learners Spend 5 minutes to review Appendix A (page 87 in the Mentor’s Guide) What aspects of learners and training activities will you need to keep track of? – Learner’s name, cadre, date the course was commenced, date the learner was found competent on all of the skills – each learner’s score on knowledge and skill assessments. 10-2

4. Possible training strategies A.Train all providers at once B.Train providers in groups of 2-4 and do not train other providers until the group has completed the entire course C.Train providers in “shifts:” Week 1: 2 providers begin Week 2: 2 different providers begin Week 3: 2 different providers begin 10-3

5. Training Logbook – Strategy A NoName Professional cadre Place of work Date training commenced Date found competent 1 AMidwifeFacility XJune 29, 2009 2 BPhysicianFacility XJune 29, 2009 3 CMidwifeFacility XJune 29, 2009 4 DPhysicianFacility XJune 29, 2009 5 EMidwifeFacility XJune 29, 2009 6 FMidwifeFacility XJune 29, 2009 7 GMidwifeFacility XJune 29, 2009 8 HMidwifeFacility XJune 29, 2009 9 IMidwifeFacility XJune 29, 2009 10 JMidwifeFacility XJune 29, 2009 10-4

6. Training Logbook – Strategy B NoName Professional cadre Place of work Date training commenced Date found competent 1 AMidwifeFacility X29 / 6 / 200917/7/2009 2 BPhysicianFacility X29 / 6 / 200917/7/2009 3 CMidwifeFacility X29 / 6 / 200910/7/2009 4 DPhysicianFacility X29 / 6 / 200910/7/2009 5 EMidwifeFacility X13/7/200924/7/2009 6 FMidwifeFacility X13/7/200924/7/2009 7 GMidwifeFacility X20/7/20095/8/2009 8 HMidwifeFacility X20/7/20095/8/2009 9 IMidwifeFacility X27/7/200911/8/2009 10 JMidwifeFacility X27/7/200911/8/2009 10-5

7. Training Logbook – Strategy C NoName Professional cadre Place of work Date training commenced Date found competent 1 AMidwifeFacility X29 / 6 / 200917 / 7/2009 2 BPhysicianFacility X29 / 6 / 200917 / 7/2009 3 CMidwifeFacility X6 / 7 / 200917 / 7/2009 4 DPhysicianFacility X6 / 7 / 200917 / 7/2009 5 EMidwifeFacility X13 / 7 / 200931/ 7 / 2009 6 FMidwifeFacility X13 / 7 / 200931/ 7 / 2009 7 GMidwifeFacility X20 / 7 / 200931/ 7 / 2009 8 HMidwifeFacility X20 / 7 / 200931/ 7 / 2009 9 IMidwifeFacility X27 / 7 / 200914/8/2009 10 JMidwifeFacility X27 / 7 / 200914/8/2009 10-6

8. Training strategy Which strategy seems the most appropriate for your facility? 10-7

9. Sessions Core Topics Review of the third stage of labour and evidence for use of AMTSL. Review of uterotonic drugs. Management of uterotonic drugs. Causes and prevention of postpartum hemorrhage. AMTSL. Additional Topics Infection prevention. Birth preparedness and complication readiness. Managing complications during the third stage of labor. 10-8

10. Work in pairs Review the suggested course schedule and prepare to answer questions How long should it take to complete the self-paced portion of Session 1? How many clinical days are required? How many learning activities are there in Session 2a? How long should it take to complete the self-paced portion of Session 4? How many learning activities are there in Session 4? How long should it take to complete the self-paced portion of Session 3? 10-9

11. Suggested time to complete each session 10-10 Topic Number of learning activities Estimated time Review of the third stage of labor and evidence for use of AMTSL. 22 hours Review of uterotonic drugs. 33 hours Management of uterotonic drugs. 33 hours Causes and prevention of postpartum hemorrhage. 44 hours AMTSL. 66 hours Infection prevention. 66 hours Birth preparedness and complication readiness. 44 hours Managing complications during the third stage of labor. 77 hours

12. Suggested course schedule The schedule assumes that each learner will study about two (2) hours per day to work through the activities/exercises for each topic. 10-11 Turn to page 25 in the Mentor’s Guide MondayTuesdayWednesdayThursdayFridaySaturdaySunday Week 1 Review of the third stage of labor and evidence for use of AMTSL. Causes and prevention of postpartum hemorrhage. Review of uterotonic drugs. Study and Review Week 2 Management of uterotonic drugs. AMTSL.Study and Review Week 3 Mid-course questionnaire Demonstrations, return demonstrations, clinical practice – 1 to 2 days Orientation

13. Work in pairs - Develop a learning plan Refer to page 1 in the Learner’s Notebook What information will need to be written in? How will you calculate due dates for each of the sessions? Why is it important to set due dates? 10-12 Turn to pages 51-53 in the Mentor’s Guide

14. 10-13

15. Group Work: Developing a training strategy Work in groups by facility (45 minutes): Review pages 49-50 in the Mentor’s Guide – “Developing a training strategy” After reading together, make a strategy for your facility that includes: ­How many providers will need to be trained? ­How will you organize distribution of modules? (Strategy A, B, or C) ­How will you advocate for clinical time for learners? 10-14

16. Monitoring (1) What data are needed to calculate: – % of women who were offered and received AMTSL oNumber of vaginal births conducted at the facility oNumber of women who were offered and received AMTSL 10-15

17. Percentage of women in the health care facility who were offered and received AMTSL 10-16

18. Monitoring (2) What data are needed to calculate: % of providers practicing AMTSL to standard ­Number of providers who received at least 80% when assessed using the checklist ­Number of providers assessed during the month 10-17

19. Percentage of providers who practiced AMTSL to standard 10-18

20. Monitoring (3) What data are needed to calculate: % of cases of PPH in women who gave birth vaginally in the health care facility ­Number of cases of PPH in women who gave birth vaginally in the health care facility ­Number of women who gave birth vaginally in the health care facility 10-19

21. Percentage of cases of PPH in women who gave birth vaginally in the health care facility 10-20

22. Thank you!!! 10-21