23/09/2023, 10:17 Strengthening new-born health workforce in Chhattisgarh by tele-mentoring | UNICEF India

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Strengthening new-born health workforce in

Chhattisgarh by tele-mentoring
UNICEF partnered with Equalize Health, a nonprofit medical technology
company, to sharpen the skills of nurses and strengthen SNCUs across the
state

UNICEF

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27 May 2022

CHHATTISGARH, India - “Nursing is one of the fine arts, the finest of fine arts,” said
Florence Nightingale, founder of modern nursing. Nurses remain the backbone of
human resources in health and help save lives.

“I am glad that I am a nurse today. It is so satisfying to know and understand the

concerns and challenges of my patients (babies) and their parents," says Prabha
Ratre, a nurse in the Special Newborn Care Unit (SNCU) in the district hospital of
Mahasamund in Chhattisgarh, India. Nurses like Prabha have been crucial in saving
the lives of many newborns in SNCUs across the country. So far, the Government of
Chhattisgarh in India has set up 25 SNCUs in 24 districts.

Recognizing the critical role of the nursing cadre in reducing neonatal mortality and
improving health outcomes, the government has prioritized the placement, skilling,
and strengthening capacities of nurses in SNCUs. Investing in nurses like Prabha is
crucial to achieving newborn health outcomes.

Leveraging Technology to Respond to Local Needs

UNICEF partnered with Equalize Health, a nonprofit medical technology company, to

sharpen the skills of nurses and strengthen SNCUs across the state. Equalize Health,
like UNICEF, shares the common goal of equitable access to quality medical care and
conducted a study to understand the need for a tele-mentoring programme. The
study results indicated that nursing staff, often overburdened, need support to
enhance capacities and confidence to tackle emergency medical situations and the
general management of cases in the SNCU. With support from the Government of
Chhattisgarh, UNICEF and Equalize Health developed the TECNeC (Training for
Enhancing Capacities in Neonatal Care) capacity building programme at scale
across all SNCUs in the state.

Since one-to-one consultation and in-person training for all nurses is near impossible
to deliver in many remote areas using traditional means, we used the innovative
ECHO tele-mentoring model. This model, combined with Equalize Health’s results-
based approach, focuses on reaching as many nurses as possible and improving
health outcomes for many newborn babies.
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Regularly scheduled, curriculum-based tele-mentoring sessions brought together

expert neonatal specialists from across the country. Nurses participating in the
programme benefited from the growth of knowledge networks, communities of
practice, and the ongoing encouragement of case-based discussions.
Online training sessions are conducted once a week. The pedagogy includes a
lecture by the expert, a case presentation by nurses, and a question and answers
session. WhatsApp focus groups ensure continued touchpoints between the nurses
and experts. The nurses utilize the WhatsApp group to ask real-time case-based
questions to the experts.

A live programme dashboard for publishing session recordings, attendance, quiz

scores, and champion nurses of the week is also included in the digital training
series.

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A baseline assessment at the start of every session followed by additional 

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impact this support will have on nursing care for newborn patients in SNCUs.
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Completion certificates to all nurses who have 70% attendance - also help build
confidence and recognition for nursing staff who have endured many pressures over
the last 12-18 months.

The programme helps address many challenges like nurses’ inability to use the
online training platform, being underconfident to voice concerns to superiors and
seniors, and presenting cases in front of a large audience. The one-to-one
counselling-built confidence increased staff morale and higher efficiency.

Since January 2021, more than 100 nurses from 25 SNCUs have been part of the
programme. Two hundred more nurses are enthusiastic and eager to be part of the
programme and trained soon.

The below testimonials from a few trained nurses highlight the transformational
change coming about in practices and processes in the SNCUs.

“I have received training for the first time. I got the opportunity to learn a lot through
this training. I am more confident in providing treatment to the patients now. I have
learned to adapt and clinically respond depending on the condition of the patient,”
says Nurse Purnima Baghel, SNCU Sukma.

“I learned regarding the improvements to be made in our SNCU to save the babies
from sepsis. I learned how to bring KMC, breastfeeding techniques, fluid, and
medicine dose management into our day-to-day practice. Now I can also manage
babies in convulsion. I gained a lot of knowledge through TECNeC. The entire team
feels like a family now. I want to thank the TECNeC team members for organizing
this training” say Nurse Nidhi Sahu, SNCU Kondagaon.

“We could change the way we administered injection in bolus. We now change the
humidifier and suction machine in every shift. We now pay close attention to the
APGAR. I learned how to operate a CPAP machine and prevent nasal injury. The
training has been helpful.” Nurse Saroj Sahu, SNCU Mahasamund.

Inputs from Lakshmi Nair, Akansha Singh, Dr. Sridhar Ryavanki, Dr. Atul Jindal, Dr.
Gajendra Singh, Job Zacharia

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