A review of SBA training suggested a need for mid term correction with regard to

operational norms. Hence the following are the revised norms for identifying trainees,

training institutions and a support supervisory structure

SBA Training

• For identifying trainees:

– In any district the delivery load in the last year in Block level hospitals, PHCs, mini PHCs and sub-centre’s will be listed;

– the S/N and ANMs in high delivery load facilities will be identified for training.

– The potential trainees need to have the core skills like BP, wt, ABD examination, HB estimation, etc (as listed in SBA Guideline of MH division)

– and be otherwise willing and able to provide delivery care services in the facilities (exclude persons too close to retirement age).

• For selection of training institutions

– The delivery load in all hospitals in the district - District Hospital, FRU, Sub-divisional Hospital, PSU hospital, ESI hospital, Railways Hospital etc – will be listed. Identify all hospitals having a delivery load more than 200 -250 deliveries/month.

– They should have core trainers i.e. OBGYN(mandatory), Senior Staff Nurses, pediatrician or MBBS Doctors trained in ENBC and Resuscitation. Only these will become training institutions.

– As a first step all service providers in these institutions will need to be oriented to and brought up to date on programme strategies and also practice all the required procedures eg. partogram, Use of MgSO4, AMTSL, ENBC and Resuscitation, Management of PPH, Infection Prevention protocols etc.

– They will then train the S/N and ANM of other institutions which are identified on the basis of delivery load.

. Supervisory Structure:

– In each state few institutions will be identified (e.g. SIHFW, HFWTC, ANMTC, Nursing schools, NGOs); each of these institutions will look after around 5 districts

– They will each recruit on a contractual basis around 2 "training experts"/1-2 districts who will supervise and mentor/handhold in close liaison with the existent training team/supervisory machinery of the district.

– They would have the task of ensuring that the trainees who come out of the training programme practice the new skills and protocols they have learnt in their facility in the services they deliver.

– The expert trainers contracted in will also help the training team in the hospital to undertake the training in addition to mentoring the trained persons later on.

– The expert trainers who are recruited on a contractual basis would be any nurse or midwife or even doctor if available who has suitable experience of labour room delivery. They will be trained in the skills of the SBA before taking up the supervisory role.

– The supervisory institutes will be strengthened in terms of their faculty and may be for every 10 districts, 1 medical officer with experience in public health will be appointed (if required) to supervise the nurse trainers recruited for the supervision.