Utilization of CSBA Training of the FWAs in reduction of maternal

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Study Title
Utilization of CSBA Training of the
FWAs in reduction of maternal and child
mortality and morbidity
Conducted by :
Center for Development Studies
Objectives of the study
The general objective of the study is to assess
the utilization status of the CSBA training of
the FWAs in the reduction of the maternal
and child mortality and morbidity.
2
Specific objectives of the study
• The specific objectives of the study
• To investigate the effectiveness of the CSBA
services in the reduction of morbidity of the
pregnant women.
• To investigate effective utilization of CSBA.
• To investigate the opinions of the community about
their services; and
• To investigate the opinions of the mothers about
the services of CSBA.
3
Methodology
• Study uses both quantitative and qualitative method
to collect data from the field.
• The quantitative data include survey of 400 trained
FWAs on CSBA course from 10 districts covering
all administrative Divisions.
• The qualitative method includes focus group
discussion (FGD) of clients, community members
and social elites.
• Five survey teams, comprising three members
each interviewed 400 trained FWAs to collect
quantitative data and conducted 6 FGDs for
qualitative data.
4
Key Findings (Basic characteristics, CSBA)
Education
Characteristics
Secondary
Secondary Plus
Percentage
56.3
43.7
Length of Services (Yrs)
21-25
82.3
Avg. Services length
21.6
In service Training : Basic Training
Arsenic contamination
EPI
Early childhood dev.
Refreshers Training
HIV/AIDS
73.5
43.5
35.8
11.8
14.8
10.5
5
Key Findings (Recall of training contents)
• Out of 41 training sessions, CSBAs remembered
those sessions more which are related to different
stages of pregnancy and its related action, home
delivery, new born child care and session related
with emergency care; and
• Remembered less which related to those
organized for creating community awareness and
related issues.
6
Key Findings: Knowledge
Subjects
Percent
Care for mother and baby during
pregnancy, delivery and post delivery
period
Pay ANC visit to the pregnant mothers at
her home not less than four times during
pregnancy period.
Care to the baby during delivery and postdelivery period’ and “identify and visit
pregnant mother within four months of
conception”
94
90
87
7
Key Findings: Knowledge
Subjects
Percent
Conduct safe delivery
Undertake active role during third stage of
delivery,
Suggest breastfeeding,
Adopt contraceptive measures
70-80
Referral of patients
Pay visit to post-partum mother three times
within 6 months of delivery and
Develop positive attitude on maternal health
among females and community members
8
Key Findings: Knowledge
Subjects
Subjects
Offer women-friendly services with due
consideration and respect to the social norms and
values,
<50
Identification of baby with LBW and respiratory
problem and take action for resuscitation, if
required”
<50
Help the new-born to get breast-fed within thirty
minutes’ time”
<50
Train the female on protective measures against
HIV/AIDS and other sexually transmitted
diseases”.
<50
9
Key Findings: Knowledge
Service standard Rank indicator (out of 6 factors)
Percent
Be attentive to patient’s problems” as rank one
indicator for measuring the standard of services
of CSBA.
43
Cordial reception to the incoming patients” was
treated as rank one indicator for measuring the
standard of services.
18
Sufficient consultation time” “maintain
cleanliness” as number one priority for
measuring the standard of services.
12-13
10
Key Findings : Utilization
• Most of the CSBA (80% and above) clearly state
that they utilized their training and performed
their assigned 30 types of responsibilities
completely which they performed partially before
the CSBA training.
• All CSBA maintained record of pregnant mother
and 83 percent CSBA maintained record of
high-risk mother.
• Services receiving clients and community
leaders are satisfied with the CSBA’s present
performance .
11
Key Findings : Utilization
• Analyzing the whole utilization pattern of all
CSBA activities it is clearly appeared that
• CSBA have performed their duties in the fields of
services related to
– ANC, PNC and delivery period,
– Timely visitation of pregnant women and referral of
high-risk women
– Counseling for breastfeeding & baby care
– Community counseling.
– Finally, CSBA have successfully maintained
record of pregnant mother and high-risk mother .
12
Lessons learned
• A considerable progress has been made in the
recruitment of CSBA for services at the community
level and their training afterwards.
• A significant number of the CSBA have shown to
have knowledge about their services, which
patient they have to refer and to where.
• That they have knowledge and sincerity in
providing services has also been reflected from
FGD of clients and community leaders.
• Community has satisfaction over the performance
of the CSBA
13
Lessons learned
• CSBA have utilized the training and handled the
visiting patients efficiently in the field of
– Dealing pregnant mothers
– Referral for emergency patient
• Visited pregnant mothers at their homes.
• But have a little lacking in dealing with the family
and the community.
• Burdened with work.
This study has found an improvement in the
knowledge and utilization of knowledge in the
performance of CSBA after the training
14
Challenges
• A few obstacles were reported from the CSBA
related with supply management. Example, lack
of weighing and blood pressure machine and the
supply of medicine.
• In reporting these problems the CSBA, Clients and
community leaders are in agreement with little
variation in their statements.
• CSBA still feel hesitant to give treatment to
incoming pregnant women with complication,
15
Recommendations
• Only a handful of 6000 CSBA have
undergone training on skilled birth
attendance against 3.25 million births taking
place each year.
– Recruitment of more CSBAs and their training on skilled
birth attendance program should continue.
• Culturally, women and the community do not feel
the necessity for skilled care at delivery. A small
number of women visit Community Clinic.
Therefore:
– There should be undertaken a two dimension program
16
Recommendations
– First, there should be recruitment of more CSBA
and be deployed after proper CSBA training;
– Regular refresher courses should be organized.
– Second, mechanism should be developed to
make the community aware of the need to seek
skilled birth attendance,
• Determine why the messages and information
about various healthcare services have failed
to attract community to get access to those
services
– There should be a review of BCC materials, and the
communication campaign mechanism
17
Recommendations
• Finally. An in-depth socio-economic study
can be undertaken in order to identify the
community perception and its related
culture. Solution should be sought from
community perspectives.
18
Thank you
19
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