National Health Mission (NHM), capacity building of concerned health functionaries and allied staff is being given prime importance. Skill based and knowledge based trainings are being implemented to improve the skills & knowledge of service providers and exclusive trainings for creating awareness to the community on availability and utilization of health care services. Based on the training needs assessment, requirement of training programmes both at institutional and field level is being prepared from district/area specific data and district programme managers plan and included in the programme implementation plan of the State. Programmes approved by the NPCC are being implemented as follows:-
- Skill based trainings; Through major Government health institutions and 7 Regional Training Institutes.
- Knowledge based trainings; Through 7 Regional Training Institutes and district /block training teams.
- Community based trainings; Through the district /block training teams coordinated and supervised by the 7 Regional Training Institutes.
Integrated Management of Neonatal and Childhood Illness (IMNCI)
IMNCI is a strategy that targets children less than 5 years old, the age group that bears the highest burden of deaths from common childhood diseases. The IMNCI strategy includes both preventive and curative interventions that aim to improve practices in health facilities, in the health system and at home. It specifies integrated case management of the most common neonatal and childhood problems with a focus on the most common causes of death. The strategy includes three main components.
- Improvements in the case-management skills of health staff through the provision of locally-adapted guidelines on IMNCI and activities to promote their use.
- Improvements in the overall health system required for effective management of neonatal and childhood illness.
- Improvements in family and community health care practices.
In Tamilnadu, as per the Government of India (GOI) operational guidelines, NHM has initiated IMNCI training in a phased manner based on IMR. IMNCI training was initiated in 2007-08 and at present all 31 districts have been covered.
The Institute of Child Health, Chennai is the nodal center for IMNCI training with a team of pediatricians and neonatologists for coordinating the planning, training and implementation of the IMNCI program.
Health and nutrition field functionaries are being trained for 8 days in IMNCI addition to the supervisory staffs who are being additionally trained for 3 more days on issues and solutions pertaining to the implementation of the programme at the grass root level.
Facility Based IMNCI Training
F-IMNCI focuses on the care of under 5 children during their stay at the health institutions. In Tamil Nadu, 22 Government Medical College Hospitals are imparting this training to the district health staff since April, 2010.
Revised Facility Based Newborn Care module integrating the additionalities recommended by GoI was then prepared by the State IMNCI Nodal Centre and Facility Based Newborn Care Programme was rolled out from Feb 2010. All the 22 Medical College faculties were oriented in January 2010.
The State IMNCI Nodal Centre has developed training modules for Facility Based Newborn Care. Training of Trainers (TOT) of 22 Government Medical College Hospitals were completed, which was then followed with in-service training of all the Pediatric & Obstetric faculty including Staff nurses of 22 Government Medical College Hospitals. With the modules for Facility Based Newborn Care and F-IMNCI from GOI, training for Master trainers for both the trainings has been completed.
Navjot Sishu Suraksha Karyakram [NSSK] training has been incorporated in the F-IMNCI training programme itself.
Pre Service IMNCI Training
In Pre Service -IMNCI training, the medical students of the Government Medical Colleges (final and pre final years) have been trained in IMNCI programme by Department of Paediatrics and Special and Preventive Medicine.
IMNCI Refresher Training
Refresher training to the health and nutrition field functionaries at regular intervals is being provided at 7 Regional Training Institutes for 3 or 4 days.
Facility Based New Born Care Training
This training is being provided at to staff nurses and Paediatrician of SNUCs followed by observership programme for 14 days at Medical College Hospitals. New Born Stabilization Unit (NBSU) training also provided to Doctors and staff nurses for 4 days.
Home Based New Born Care Training (HBNBC)
Healthy new born with adequate birth weight will be staying at the health institutions for about 48-72 hours only. By then, the mother has to be oriented and guided towards neonatal and infant care practices so as to empower her to identify the early warning signs of sick newborn when she returns home. Health volunteers, SHG members & NGOs in the districts have been trained by the health staff to reinforce the practices and help mothers identify sick newborn and refer them back to the hospital in time and counsel and guide the mothers during the house visits. 1,500 Anganwadi workers have been provided training in HBNBC in 15 high IMR blocks. About, 2650 ASHAs working in tribal and hard to reach difficult areas have also been trained in HBNBC. (6th and 7th module)
Active Management of Third Stage of Labour Training (AMTSL)
A three day training was imparted to the PHC Medical Officers to improve their skills to prevent the maternal deaths due to post-partum hemorrhage (bleeding occurring after delivery causing death of the mother due to over bleeding) and due to various reasons like anemia, PIH (Pregnancy Induced Hypertension).
SBA Training (Skilled Birth Attendant)
Skilled Birth Attendant training is imparted to PHC staff nurses to improve their skills for conducting normal deliveries, identify high risk deliveries and early referral and care of mother and newborn baby during and after delivery.
BEMOC Training (Basic Emergency Management of Obstetric care)
This is a six days training being imparted to the medical officers to update their skills in managing complications arising during intra natal period.
EmOC Training (Emergency Obstetric care)
24 weeks training is being imparted to MBBS qualified medical officers to effectively manage 3rd stage of labor and high risk cases during labor. ISO & KGH, Triplicane, Chennai is the nodal center for this training and it also acts as a Tertiary Training Centre with Government Medical College Institutions ,Trichy, Tirunelveli, Madurai and Coimbatore responsible for district training.
Certified by Federation of Obstetrics and Gynecology of India (FOGSI) and AVNI foundation, an NGO is authorized by FOGSI monitors the EmOC training.
LSAS Training (Life Saving Anaesthesia Skills for Emergency Obstetric Care)
Life Saving Anesthesia Skills for Emergency Obstetric Care is being imparted to MBBS qualified medical officers for 24 weeks in 11 Government Medical College Institutions. The training provides training in Obstetric Anesthesia and in Cardio-pulmonary cerebral resuscitation.
RTI/STI Training (Reproductive Tract Infection / Sexually Transmitted Infection):
A three day training was imparted to the medical officers and two day trainings is being imparted to the staff nurses and lab technicians to upgrade their knowledge in Syndromic approach for diagnosis and treatment of Sexually Transmitted Diseases.
IRT Training (Integrated Refresher Training)- Supervisors:
This training is being imparted to all the female supervisory functionaries such as Community Health Nurses and Sector Health Nurses as on refresher course all ongoing programmes and their monitoring tools and activities.
IRT Training (Integrated Refresher Training)- Laboratory Technicians
This hands-on-training is being imparted to all laboratory technicians of the PHC to handle semi- auto analyzers and other lab equipment.
Managerial Skill Training for Medical Officers
This training for 15 days is being imparted to all the newly recruited medical officers on orientation to all health programmes being implemented and also on their administrative role in the PHCs. The trainings are being conducted in 7 Regional Training Institutes.
Maternal and Child Health Skill Lab Training
This hands-on-training is being imparted to all the medical Officers and staff nurses related to maternal and child health in the skill labs established in Regional Training Institutes.
RMNCH+A training to staff nurses in identified CEmONC/ NICU
This training provides hands-on-training on MCH Skills especially in CEmONC and NICU practices to the newly recruited 7700 staff nurses in the health department. It is being conducted in 40 CEmONC /NICU centers having more than 200 deliveries per month with 21 days in CEmONC and 14 days NICU.
The priority has been stratified for staff nurses having poor core assessment score (JHPIEGO OSCE POST TEST SCORES) have completed first. The Obstetricians and Pediatricians are being the resource persons for these trainings.2000 staff nurses were trained so far.
National Nodal Centre NNC College of Nursing, Chennai
This centre acts as a Centre of Excellence for the pre-service education for nursing-midwifery cadre in the region/ state and would contribute to the overall strengthening of nursing-midwifery cadre in the region/ state.The first batch of training with 15 participants commenced from November 7th to December 17, 2016.
This six weeks training course for ANM/GNM faculty aimed at strengthening their teaching skills, knowledge and skills in MNCH, FP and clinical care with which, they transmit the same to their students in their colleges. Post training mentorship visits are being conducted in order to provide support to the trained faculties.
Training Adolescent – Friendly Health Services ( RKSK-AFHS)
A four days training was imparted to the medical officers and five days trainings for ANM/LHV is being imparted to upgrade their knowledge in Syndromic Approach in Reproductive & Sexual Health, Nutrition Injuries and Violence (including gender based violence), Non-communicable diseases, Mental Health and Substance misuse services to adolescents.
The Peer Educators who are selected by members of VHSNC based on their educational qualification, communication skills, motivation and interest to lead RKSK activity.
The Peer Educators (PEs) in the programme are adolescents between 15 and 19 years of age. PEs will undergo six days of non residential training concerning various components of RKSK. These trained PEs will be the most important link between the service providers and the adolescents in the community and hence will be the key to the success of the RKSK.
Rashtriya Bal Swasthya Karyakram Training ( RBSK)
Government of India’s initiative, Rashtriya Bal Swasthya Karyakram (RBSK) is a child health screening and early intervention service with the aim to screen all the children from 0-18 years for four Diseases - Defects at Birth, Diseases, Deficiencies and Developmental Delays including Disabilities. 770 Mobile Health Teams including medical officers, staff nurses and pharmacists have been trained for 5 days in 6 of the 7 Regional Training centers after completion of TOT at Chennai.