Vocational Training Team Report – November 2022.

The Vocational Training Team (VTT) arrived in Freda Carr Hospital, Ngora, on the 24^th of November and started on the 25^th November 2022. A warm welcome was given to the training team by the nursing and midwifery students.

The VTT were honoured to be invited to the centennial celebrations of Ngora Freda Carr Hospital. It was notable how important the hospital was to the local community and how it impacts on their health.

Aims and Objectives

Nursing and Midwifery Students

The nursing and midwifery students were due to have national exams from the 5^th of December. We were asked to cover the partogram and the initial assessment of the woman as well as the anticipated Birth Emergencies, Neonatal Resuscitation and Infant Feeding training programme.

Samantha Fleming and Gillian Pearce did the obstetric emergency skills drills. We covered assessing the woman and the use of the partogram to monitor progress in labour. The key areas we covered were obstetric haemorrhage, shoulder dystocia, sepsis, malaria and answered any questions they had.

Lydia Franklin led neonatal resuscitation, neonatal sepsis and Claire Carter covered infant feeding and care of the premature baby. Lydia made the neonatal resuscitation more realistic as the baby did not always deliver on the labour ward but may have delivered when arriving at the hospital, so she covered the key aspects in an imaginative way which made it fun. The neonatal resuscitation followed international standards and we did include how to suction the baby appropriately.

Health Professionals

The training was given to nurses and midwives but also to other support personnel. The reason for this is that in some health centres they might be the only other person present, and, in an emergency, more than one person is required.

Sam and Gillian covered shoulder dystocia, postpartum haemorrhage, infection, malaria, breech, and eclampsia. Claire and Lydia covered Neonatal resuscitation, neonatal infection, kangaroo care and infant feeding specifically for the preterm baby as requested.

Community Workshop

Following the technical cadre’s report that the VTT needed to involve the local community. An arrangement was made with the support of the District Health Officer to do a workshop on the importance of recognising when to refer a pregnant woman or baby to a health centre. The Village health workers were invited which included teenage supporters from the “Adolescent Clinic” Pregnant women are expected to deliver in the local health centre. However, some women will not make it to the local health centre in time. Therefore, we covered care of the cord and how to recognise the sick mother and baby emphasising the importance of early transfer to hospital. Claire covered feeding and how to do kangaroo care. This entire session was done in Teso which is their local language. Three people helped with translations.

Local Charity delivered training on Menstrual Hygiene

The previous VTT in 2019 identified the need for highlighting the importance of menstrual hygiene and the use of reusable sanitary pads (Afripads). The trainer came from Soroti and gave a talk to students and health professionals on 2 different days. The trainer discussed the importance of personal and menstrual hygiene and the use of reusable pads. The trainers helped the group to understand the impact on a girl’s life and her confidence without a shared knowledge of how to manage this issue. The trainers gave the talk in Teso when they did their training at the community workshop, it allowed the attendees and trainers to have a fruitful discussion and occasionally there were questions to the VTT about what caused infertility and how this could be managed. There were also questions about intermittent bleeding during the month. This resulted in discussions about when to refer for a medical review.

There were two trainers came to the community workshop. They gave their talk on menstrual hygiene but they also taught the group how to make reusable pads using cotton cloth and flannel to absorb the menstrual loss. There was a discussion on how to care for the pads both in how to transport them after use and how to clean them.

Train the Trainer Session

A session was done with the trainers who will be taking the training forward. We also covered how to do fundal height measurements at the request of the Senior Nurse. We asked them to teach us on how to resuscitate a baby which they did. They had the opportunity to ask more in-depth questions and a chance to clarify and practice the different scenarios.

Training

Table on training attendance

Health Professional	Numbers
Nursing and Midwifery students	75
Health Professionals	149
Community Workshop Attendees	82
Train the trainer session (1 doctor included)	11

The health centres who sent staff for training were: –

The Vocational Training Team (VTT) arrived in Ngora Hospital on the 24^th of November and started on the 25^th November 2022. A warm welcome was given to the training team by the nursing and midwifery students.