Objective : To assess the present status of pre-service education in two identified ANMTCs of Uttarakhand and suggest measures for improvement, if any. The specific objective is to conduct an assessment using the performance standard checklists. It was also to suggest measures for improvement based on identified gaps.
Background : Government of Uttarakhand with technical assistance from USAID supported MCHIP have stepped towards addressing the quality pre service Maternal, Newborn and Child health (MNCH) and Family planning (FP) education of Auxiliary Nurse and Midwives (ANMs) in Uttarakhand. For this purpose two ANMTCs (Rani Pokhri, Dehradun and Gadarpur, Udham Singh Nagar) have been identified by the state for strengthening. The goal of the study is to improve the quality of pre service maternal, newborn and child health and family planning education of ANMs at two identified ANMTCs in Uttarakhand.
Methodology : The study area is ANMTC Rani Pokhri, Dehradun and Gadarpur, Rudrapur. The study Design is Cross sectional Study. The type of Sampling is Purposive. The collection of data was done by observation and interview with the help of performance standards. The performance standards are based on the Indian Nursing Council (INC) norms and have been discussed and approved by the principals and senior tutors of both the auxiliary nurse midwife training center. This helped to increase the acceptance of the intervention of the gaps found during the assessment. There are total 78 performance standards. For every performance standard there are verification criteria. Only if all verification criteria’s are fulfilled only then one score is given otherwise the score is zero.
Findings : It was found the ANMTC Rani Pokhri and ANMTC Gadarpur could fulfill 40% and 44 % respectively of the total performance standards. It was found that there is acute shortage of the availability of staff at both ANMTC’s. The non-availability of adequate staff was hampering not only the teaching but also the learning of students at clinical area as tutors were not able to accompany the students at the clinical site. Written job responsibilities with staff and performance evaluation system were not available at any of the ANMTC’s. Reference and course material as per INC norms were either not available or were less in quantity in library and among student. The teaching methodology used is traditional and the update about the Maternal, Newborn and Child health (MNCH) /FP was also outdated. The infrastructure of the school was not satisfactory. Basic amenities like computers, LCD projector, printer,photocopy machine, telephone was unavailable. Many of the anatomical models were not available at the both ANMTCs. The infection prevention practices were observed in the labor room and were found inadequate in terms of segregation of bio-medical waste and hand washing practices. Although the clinical rotation plan for students was followed at both ANMTCs, but the same was not being shared with all the clinical sites. However, doctors and staff of one of the clinical area were regularly taking practical classes and examination of the ANM students and giving feedback to the school.
Recommendations : Liaising with the state and Chief Medical Officer for making staff available for training of senior tutors. Regular updation of knowledge on MCHN and FP, teaching methodology needs to be updated. Reference and course material as per INC norms should be procured. Evaluation system to be developed and feedback from student also should be introduced. Providing the learning guide/checklist during the demonstration at clinical area/school should be taken into consideration. Providing Infection Prevention training to ensure infection prevention practices by the staff and trainers of clinical area. Ensuring the availability of the equipments, supplies and drugs in clinical area. PPFP training recommended for all staff to ensure general or method specific postpartum family planning counseling given to client during ANC and PNC visits.
To assess the present status of pre-service education in two identified ANMTCs of Uttarakhand