Ten practicing clinicians from 10 African Union member states have been trained to instruct other experts in reducing maternal mortality across Africa. This five-day Emergency Obstetric and Newborn Care (EmONC) course, organized by Africa CDC, took place in Nairobi, Kenya, from June 2-8, following an initial course held last December.
Among the ten trainees were seven reproductive and maternal health managers from their countries' national ministries of health. These participants were selected from last year's course and were joined by technical, administrative, and communication officers from Africa CDC.
"Comprehensive Emergency Obstetric and Newborn Care Management is a widely documented strategy that has significantly contributed to the reduction of maternal and newborn mortality. Equipping clinicians with these skills will greatly reduce maternal and newborn mortality in Africa," said Dr. Abdulaziz Mohammed, Head of Disease Control and Prevention at Africa CDC in Addis Ababa.
Dr. Mohammed emphasized that adopting this approach for EmONC training empowers member states sustainably to reduce maternal and newborn mortality. He cited the Africa CDC online Reproductive Health priority survey, which highlighted the need to build clinician capacity in EmONC as a critical priority.
The capacity-building training included a combination of lectures, hands-on practice, group activities, and engaging discussions. The areas covered were extensive, including managing and facilitating group discussions, interpreting partographs, teaching skills, conducting Objective Structured Clinical Evaluations (OSCEs), assisted vaginal delivery techniques, documentation and audit of practice, adult and newborn resuscitation, surgical skills, and managing post-cesarean hemorrhage scenarios.
The training was based on the WHO's 2023 Ending Preventable Maternal Mortality/Every Newborn Action Plan Report, addressing the skills gap in providing quality intrapartum and postpartum care to reduce mortality across the continent. Coordinated by three obstetricians from the University of Nairobi, led by Professor Charles Ameh, the training also involved Africa CDC's Regional Coordinating Centers (RCCs) to facilitate training in different regions and countries.
"To coordinate the regional training led by the RCCs, it was essential for the RCCs' reproductive health focal persons to understand the logistical and administrative aspects of organizing such training," said Dr. Mohammed. "This involvement also helped them understand the procedures and skills required, preparing them to lead training at regional and country levels for sustainability."
Participants discussed the essential elements needed to implement the training of trainers in each RCC, including advocacy, procurement of training equipment, and increasing the number of trainers in member states. They agreed on the necessity of a national training rollout, followed by monitoring and evaluation.
The next step is to cascade the training to the five RCC regions and eventually to individual African Union member states for sustainability. "The initial master training targeted 25 African Union member states with the highest maternal mortality rates. This was followed by training ten clinicians identified in the initial training by Africa CDC and the faculties," said Dr. Mohammed. These trained clinicians will form a continental team of trainers and lead regional training, reducing the need to hire external consultants and training equipment.
Dr. Ebba Secka, Africa CDC Senior Technical Adviser, will refine plans to spread EmONC training across regional countries. The training aims to improve future training workshops, with all materials translated into Africa CDC's official languages and ongoing review and monitoring to ensure a critical mass of national trainers. Africa CDC is called upon to support countries with the worst maternal health indicators and strengthen evidence-based EmOC training at health worker training institutions for sustainability. In alignment with Africa's New Public Health Order, Africa CDC established a Reproductive Health unit under the Division of Disease Control and Prevention to support and accelerate the implementation of the Maputo Plan of Action (MPoA) 2016-2030. This unit forms part of the overall Africa CDC five-year strategy (2022-2026) and focuses on accelerating the reduction of maternal mortality by addressing key components identified by member states as lagging behind.