Short training courses in managing emergencies in pregnancy, the newborn and the child throughout The Gambia

From 2006 to 2014, approximately 940 health workers underwent training led by the Advanced Life Support Group (ALSG).  The following courses were undertaken:

 

  • 3 day training in emergency maternal and neonatal healthcare (EMNH) for doctors, midwives and medical students. Click here for content.

 

  • 3 day training in emergency child and major trauma care (ECTH) for doctors and nurses. Click here for content.

 

 

  • 2 day generic instructor course for attendants on the above course who achieved high results and who manifest enthusiasm and aptitude to become ALSG instructors. Click here for the manual for this course.

 

The training comprised both  personal study and face to face skills training and problem solving in small groups.

 

 

Candidates have a study book to learn from before the course. Important concepts are reinforced and discussed in some short lectures. Emergency skills, such as airway management , bag/mask ventilation, circulatory access and emergency obstetric manouvres and resuscitation at birth are taught until all candidates can perform the skill. Then the candidates are presented with a practical diagnostic and treatment problem in which they enact the treatment and patient progress with manikins and equipment. A final assessment to ascertain whether an acceptable standard has been reached by each candidate completes the three days.

 

 

The "train the trainers" course concentrates on facilitating the best and most motivated candidates to pass on their learning by gaining the educational skills to teach this hands-on training effectively.

 

 

Each of the candidates on the above courses receive the following items at the end of each course:

 

  • A self inflating bag and two masks for lung inflation during emergencies 

  • A manual on emergency care for pregnant women, babies and children 

  • A logbook to enter details of every emergency intervention learned on the courses for monitoring and evaluation purposes and also for personal satisfaction 

  • A battery operated calculator (for the newborn course)

  • A nurse's fob watch (for the newborn course)

  • A low reading thermometer (for the newborn courses)

  • A stethoscope (for the newborn course)

The Gambia, in common with other low resource nations has Traditional Birth Attendants and Village Health Workers who have received a basic training, usually from the government. Most are illiterate so their manual was, of necessity, pictorial. The TBAs were each given a mobile phone so that if any of the emergency situations described pictorially in the manual occurred, they could institute a first aid measure and phone for the Brikama emergency ambulance (Flying squad system described below)

 

  • 2 day training in the recognition of emergencies and first response management, including resuscitation of the newborn, for traditional birth attendants in the Basse and Brikama regions: to become incorporated in the Emergency Ambulance response system described above (Flying Squad).  Click here for content and click here for the manual.

 

 

International MCAI and ALSG volunteer experts from the UK led the above courses initially, but later it was possible for Gambian ALSG accredited trainers who had successfully completed the courses to lead on subsequent training.  UNICEF and UNFPA supported many of these later training courses. 

 

Three of the Gambian instructors (all midwives) also taught on EMNH courses in Liberia and in Istanbul at an international paediatric conference.

Gambian instructor training traditional birth attendant in resuscitation of the newborn infant

Training of midwives and doctors in newborn resuscitation

Training midwives in the insertion of an intraosseous needle for the treatment of shock where intravenous access is not possible

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