Evaluation of SIMESON, A Training Program to Improve Access to Quality Health Care for Pregnant Women and Newborn in Different Health Care Facilities of Northern Bangladesh

Abstract

Background: Access to perinatal health care is improving in Bangladesh, but maternal and neonatal mortality is still a public health concern. SIMESON (simulation for essential skills for obstetrical and neonatal care) training was focused on expanding maternal-newborn health services for safe delivery by improving infrastructure, perinatal knowledge, and skills of health care providers working in health care facilities in northern Bangladesh. Our objective was to explore the current knowledge and skills of health care providers already trained by SIMESON, in reviewing perinatal health situation including the current status of health care facilities, cost estimation and most importantly delivering perinatal health services.Methods: It was an observational study involving 88 health care providers working in 20 health care facilities. Cost estimation following both quantitative and qualitative approaches was also attempted. Result: Knowledge and skills of health care providers regarding the provision of normal delivery and immediate postpartum care, management of postpartum hemorrhage (PPH), and retained placenta; and use of the bag and mask ventilation to help a baby breathe were found to be considerably strengthened following SIMESON training. During the 6 months after training, there were 477 PPH cases managed successfully with only 1 death; neonatal deaths observed were 6.6 per 1000 live births; twice the number of facility deliveries; and 80% use rate of Ambu bag for helping baby breathe. The estimated cost per trainee was 395.68 USD, and 5.85 USD per beneficiary.Conclusion: SIMESON training improved maternal and child health by facilitating the health care professionals’ improved knowledge and skills, enhancing access to health care facilities, and increasing facility delivery. Such a training program should be promoted within health system in hard-to-reach areas of the country that are burdened with other commitments.