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Lessons Learned
HBB, ECEB, ECSB for 126 Catholic sisters and providers at their clinics. Taught by 3 locally trained Master Trainers
Master Trainer course on HBB, ECEB and ECSB for trainers that will be teaching Catholic sisters/nurses and their clinic staff
7/13/2017HAITIWilhermina; Michelucia; Werbel; Aneji Jean Baptiste; Casseus; Werbel;
This course was taught in Haiti.
7/12/2017HAITIChiamaka; Alice; Michelucia; Wilhermina Aneji;Werbel;Casseus;Jean
Having 2 learners among the group who were experienced in newborn care was very useful. We engaged them in modeling/demonstrating some of the desired skills to the class. This was very useful in getting the audience well engaged.
1) Know your audience and each learner's responsibilities in the healthcare system in which you are working and plans for using the course; 2) Have an MOU with clear expectations and plans for a follow up within a 3-6 month period; 3) If possible, arrange a refresher course and follow-up discussions and feedback within a few months; 4) Written materials are needed in the language of the learners for ECEB and ECSB;5) Helping Mothers Survive needs to be closely connected and taught with the HBS curriculum.
We were teaching pediatric residents and the resuscitation concepts were entirely new to them. 
Great facilities for teaching. Used an excellent interpreter.  all had attended deliveries before. Practicing was the most important part of the program. HSC is starting deliveries this month; would love to bring more equipment and have been asked to do more training.Taught 8 nursing studetns(senior ) and 3 docs. More nursing studetns watched.
Mastering the use of the bulb syringe for the hardest.The men in general were faster learners fwith the bulb syringe. We practiced both days with cups of water.Mastering the bag and mask technique wqa easier for most.
The midwives clearly had difficulty with suctioning and bagging, we did not certify them at this time. The doctors, nurses and nursing students were quite capable of teaching the course.The more materials available in Creole the better.we did learn that the TBAs had an extremely conservative level of referring women who presented at risk for difficult births to the hospital, which was an excellent surprise, they clearly recognized high risk scenarios and immediately referred them. they had all done the course before and knew of the importance of cleaniness and timeliness. Their dexterity was a limiting factor. The nurse and nursing students were great at all techniques as was Dr. Brinvert who is a master instructor now.
The bag mask skill was difficult for some of the birth attendants. Others were able to achieve the skill very easily. Age and sex did not make a difference.I trained a 3rd year medical student first and she helped with the class.The 2 nurses did very well.
We taught HBB to 11 TBAs and 2 midwives at Sacre Coeur Hospital in Milot.  We had a great experience and were gratified to see the TBAs really grasp the material we taught.  At the end of the class, the TBAs were given clean birthing kits that included a suction bulb, towels, umbilical ties and a stethoscope.  The kits were confiscated by hospital personnel after the class, however.  Evidently, in Haiti, possession of a stethoscope can bestow doctor-like status on someone.  The hospital did not want this to happen unless they had a better handle on the competency of those that we trained.  Evidently, an unscrupulous TBA could possibly use a stethoscope as a false profession of status.  People who teach HBB in Haiti in the future need to know of this cultural aspect of health care when there.Assistant Instructors:Andrea Lotze, MDMichele Drapeau-Clem, RNGuylene GAston, RN Nneke Matlock, RN
It was a great asset to our program to certify our translators in Helping Babies Breathe.
1/1/2012HAITIKathleen Braico
The translator learned as much as the students (or more!), and he was used to teach 3 courses.  He is non-medical, but at this point he could actually teach the course!  Can we make him a facilitator?We planned on 4 students, and had 11, so we did not have enough ambu bags to give them.  We gave each of them a stethoscope and bulb syringe, however.  Afterwards we learned that this was NOT acceptable because "if you have a stethoscope and a certificate people think you are a doctor and they could act as one."!  This was a great surprise to us.  I wonder about the usefulness of a stethoscope anyway, if they master feeling the umbilical pulse.  It is not easy for them to use.  We could not make them take the "written" test as it was not in Kreyole, they had no idea of what multiple choice meant, and there were time constraints (in Haiti you are done at 3 pm no matter what, they need to get home before dark.)  That is why I put "0" for number passed in that column.  We discussed the questions in general but I could not test 11 people individually verbally. If I had been able to give them an ambu bag, we did not have time to disassemble and reassemble it.  There are so many parts, including the small yellow gaskets, that I feel it would take repeated teaching sessions to be sure they reassembled it correctly.  It is actually quite difficult to disassemble, and I fear there would be risk of breakage.  We did leave them with the local clinic nurses who took the course.  Can't it be boiled "whole" with only taking the mask off? Again, due to the time constraints, we "combined" OSCE A and B for the final test.  I made each of them demonstrate the bag mask skill on 3 separate occasions to be sure that they really knew how to do it and they did not achieve chest rise "accidentally". Suctioning is a difficult skill to teach, and went better when we did it hand over hand with them.  We took the hand washing diagram to Kin
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