Strengthening healthcare providers’ capacity for intra-uterine device and contraceptive implant services in humanitarian and fragile settings: a case study from Nepal

Volume 6, Issue 2, April 2022     |     PP. 28-43      |     PDF (293 K)    |     Pub. Date: July 6, 2022
DOI: 10.54647/pmh33204    86 Downloads     15559 Views  

Author(s)

Kamille Gardner, CARE, 151 Ellis St NE, Atlanta, Georgia 30303, USA
Shabana Zaeem, CARE, 151 Ellis St NE, Atlanta, Georgia 30303, USA
Jagadishwor Ghimire, Ipas Nepal, Do Cha Marg, Baluwatar, Kathmandu, Nepal, PO Box 11621
AKM Anisuzzaman, CARE Cox’s Bazaar, Sayeman Heritage Residence, Gate# 1, Baharchara, Cox’s Bazar 4700, Bangladesh
Bergson Kakule Syaivuya, CARE Democratic Republic of Congo, 24, Avenue des Acacias, Goma, North Kivu, DRC
Alison Greer, Training Partnership Initiative of the Inter-Agency Working Group on Reproductive Health in Crises, Women's 5Refugee Commission, 15 West 37th Street, New York, NY 10018, USA
Anushka Kalyanpur, CARE, 151 Ellis St NE, Atlanta, Georgia 30303, USA
Nguyen Toan Tran, Training Partnership Initiative of the Inter-Agency Working Group on Reproductive Health in Crises, Women's 5Refugee Commission, 15 West 37th Street, New York, NY 10018, USA; Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, PO Box 123, Sydney, NSW 2007, Australia; Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206 Genève, Switzerland

Abstract
Background – Access to modern family planning methods, including long-acting and reversible contraceptives (LARCs), to prevent unplanned pregnancy is critical to avert maternal deaths in humanitarian and fragile settings, where clinicians often have limited LARC competencies. This paper explores the perspectives and recommendations of providers and trainers involved in piloting the Clinical Outreach Refresher Training for Sexual and Reproductive Health module (S-CORT) on LARCs in Nepal.Methods – Qualitative data from end-of-training evaluations, which were self-filled by 15 trainees, a focus group discussion involving 11 of them, and written feedback from five co-trainers were transcribed, coded, and thematically analyzed. Results were intersected with those from pilots held in Bangladesh and the Democratic Republic of Congo.Results – Results suggest that the module could increase participants’ counseling and clinical skills, help anchor readiness for family planning and LARC provision before humanitarian emergencies, and reinforce informed consent, service privacy and confidentiality, and access for underserved populations, including adolescents. Recommendations for improvement included the advanced provision of the learning resources for self-study to promote blended learning and avail more clinical practice time.Conclusions – When the lack of skilled human resources is a barrier to LARC services in humanitarian and fragile settings, the S-CORT strategy could offer a rapid hands-on refresher training opportunity for clinicians requiring knowledge and skills update. Such a capacity-development approach could be valuable not only for emergency response but also in contexts prioritizing disaster preparedness planning.

Keywords
Long-acting and reversible contraceptives, contraceptive implants, intra-uterine devices, capacity strengthening, refresher training, human resources for health, humanitarian settings, preparedness, sexual and reproductive health and rights

Cite this paper
Kamille Gardner, Shabana Zaeem, Jagadishwor Ghimire, AKM Anisuzzaman, Bergson Kakule Syaivuya, Alison Greer, Anushka Kalyanpur, Nguyen Toan Tran, Strengthening healthcare providers’ capacity for intra-uterine device and contraceptive implant services in humanitarian and fragile settings: a case study from Nepal , SCIREA Journal of Health. Volume 6, Issue 2, April 2022 | PP. 28-43. 10.54647/pmh33204

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