Background
Nepal’s maternal mortality rate is among the highest in the world. Excessive bleeding after childbirth, known as post-partum hemorrhage, is one of the major causes of maternal death. Evidence shows that routine use of a method called active management of third stage of labour (AMTSL) reduces the risk of excessive bleeding. Unfortunately, many health workers in Nepal often don’t provide all the components of AMTSL, which means it is being performed incorrectly.

About the project
This project was created to promote the use of AMTSL in Surkhet district. The project team trained 47 health workers, including nurses, auxiliary nurse midwives and maternal and neonatal health workers from 20 different health institutions in the district. The training consisted of discussions, lectures, brainstorming sessions, video screenings, demonstration and individual practices on anatomic models. The project team also visited some of their participants in their workplaces, to follow up how they were using their skills after the training.

Results
By the end of the project the health workers had improved their knowledge and skills on active management of third stage of labour. The health workers were given a test before the training, where the average score was 58%. After completing the training, the average score was 91%. During the follow-up visits by the project team, all participants who were examined could demonstrate their AMTSL skills and answer questions almost perfectly.

Year: 2010