How do you plan to significantly scale-up educational facilities and mechanisms in obstetric fistula units. And what exactly do you mean by scaling them up?
Many thanks for your comment, and sorry for the delay in my response. I've been travelling and internet connection is touch and go!
When I speak of "scaling up" I mean building on existing education programmes. To that end, I would recommend facilities continue to utilize the same educators in use before. I am speaking from my experience at the Hopital National de Niamey, Niger, where multiple educators are in place and could easily adapt the programmes to a more "rigorous" community health worker course. By no means would I expect the women to come out fully trained in obstetric care - however, I do believe basic reproductive health issues could be conveyed through simple courses presented for the duration of a fistula patient's recovery. One or two educators is all who would be necessary, as I know not every woman would be willing or capable of undergoing such an educational programme. A possible schedule would be 2-3 days a week, 1-2 hours instruction, covering basics of family planning, pregnancy (particularly detecting signs of a traumatic pregnancy), labor/delivery, and breastfeeding.
The main point would be to educate the women on how to recognize when a pregnancy and labor/delivery are going awry. Transmitting this basic knowledge to women in smaller communities could help them prepare to travel to medical facilities in capital cities, most of which provide free c-sections and maternal healthcare (speaking of Niger, but this may change with the junta!).
I like your idea but I was wondering how you would train them especially taking into account possible educational differences and education levels. Also who would take over the jobs in the hospital for those people that would train in the community?
Thanks so much for your comment! In terms of education levels, I understand completely that these differ vastly among fistula suffers - some are literate, others are not, but even those who are literate will likely have a very limited knowledge of reproductive health (most women in the world, including developing countries know very little about pregnancy and how their bodies work, even if they have a college degree!). So I would structure the curriculum at the most basic level, with visual diagrams/images that could allow literate and non-literate women the same environment of learning. I would assume that only a few women at any time would want to engage in the learning process, so I would hope that the instructor would then have plenty of time to coach those who struggle more due to a lack of previous educational background.
As to your second question, I don't anticipate any direct training in the communities: all education would take place at the hospital facilities. And again, I am not asking for an intensive nursing course: I think a very basic expansion of existing educational services, i.e. teaching the women basic tools to detect high risk pregnancies and early signs of stressful labour so they can help other women with such symptoms get to an appropriate health facility (usually in an urban environment) ASAP, rather than waiting for the labor to become more complicated and the risk of fistula, eclampsia, or death becoming greater. So no additional staff should be required at hospitals which already have existing educational programmes.
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How do you plan to significantly scale-up educational facilities and mechanisms in obstetric fistula units. And what exactly do you mean by scaling them up?
Many thanks for your comment, and sorry for the delay in my response. I've been travelling and internet connection is touch and go!
When I speak of "scaling up" I mean building on existing education programmes. To that end, I would recommend facilities continue to utilize the same educators in use before. I am speaking from my experience at the Hopital National de Niamey, Niger, where multiple educators are in place and could easily adapt the programmes to a more "rigorous" community health worker course. By no means would I expect the women to come out fully trained in obstetric care - however, I do believe basic reproductive health issues could be conveyed through simple courses presented for the duration of a fistula patient's recovery. One or two educators is all who would be necessary, as I know not every woman would be willing or capable of undergoing such an educational programme. A possible schedule would be 2-3 days a week, 1-2 hours instruction, covering basics of family planning, pregnancy (particularly detecting signs of a traumatic pregnancy), labor/delivery, and breastfeeding.
The main point would be to educate the women on how to recognize when a pregnancy and labor/delivery are going awry. Transmitting this basic knowledge to women in smaller communities could help them prepare to travel to medical facilities in capital cities, most of which provide free c-sections and maternal healthcare (speaking of Niger, but this may change with the junta!).
Hope this helps to clarify. Thanks again!
I like your idea but I was wondering how you would train them especially taking into account possible educational differences and education levels. Also who would take over the jobs in the hospital for those people that would train in the community?
Thank you again for your entry!
Hi!
Thanks so much for your comment! In terms of education levels, I understand completely that these differ vastly among fistula suffers - some are literate, others are not, but even those who are literate will likely have a very limited knowledge of reproductive health (most women in the world, including developing countries know very little about pregnancy and how their bodies work, even if they have a college degree!). So I would structure the curriculum at the most basic level, with visual diagrams/images that could allow literate and non-literate women the same environment of learning. I would assume that only a few women at any time would want to engage in the learning process, so I would hope that the instructor would then have plenty of time to coach those who struggle more due to a lack of previous educational background.
As to your second question, I don't anticipate any direct training in the communities: all education would take place at the hospital facilities. And again, I am not asking for an intensive nursing course: I think a very basic expansion of existing educational services, i.e. teaching the women basic tools to detect high risk pregnancies and early signs of stressful labour so they can help other women with such symptoms get to an appropriate health facility (usually in an urban environment) ASAP, rather than waiting for the labor to become more complicated and the risk of fistula, eclampsia, or death becoming greater. So no additional staff should be required at hospitals which already have existing educational programmes.
Hope this helps and answers your inquiries!!
all the best,
Julianne.
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