THE GYNECOLOGICAL TRAINING OF ANM (MIDWIFE) REPORT DECEMBER 2019
Date: 2019 Dec 21st to 24th – First cohort of five ANM and
Dec 25th to 28th - Second cohort of five ANM
Place: Gajuri Primary Health Centre
Gajuri Rural Municipality
Dhading District, Central Nepal
10 AMNs from village health posts and primary health center of Gajuri Rural Municipality
Trainers: Dr. Richa S of Shankarpur Hospital & Dr. Sunita T of Patan Hospital
Implemented by: Himalayan HealthCare
HHC had discussed with the District Health Office in regards to expansion of this training to other rural municipalities in the Dhading District region where HHC has been active since 1992. Gajuri Rural Municipality was selected as the next center for ob-gyne training in 2019-2020 after Ruby Valley RM in 2018-19 after they requested for such training. Gajuri RM also has health posts in remote village sites where HHC has built health posts and also equipped and furnished them after the earthquake devastation of 2015. Helping the midwives with gynecological training was a continuation of our support to this rural municipality as well as improving services to the women patients of the region.
Gajuri Primary Health Centre or PHC where the training was conducted is three hours’ drive from Kathmandu and two hours from the Dhading District HQ of Dhadingbesi and is the center of the region but the participants had to travel for several hours to reach this center from other village sites which are spread out in the region. HHC field health supervisor Phe D and Dhading coordinator Kul M escorted the two ob-gyne specialists as well as a nutritionist and a blood transfusion expert from Patan Hospital as well to Gajuri for the training in two different groups. They all were provided food and stay at a local hotel during the eight days training period.
21st – 24th December 2019
Ob-gyne facilitator - Dr. Richa S, Shankarpur Hospital, Kathmandu
Ranjana S, ANM, Pida HP
Yeshoda U, ANM Kiranchowk
Radha P, Staff Nurse, Gajuri PHC
Amrita Pa, ANM, Gajuri PHC
Amrita Po, ANM, Gajuri PHC
25th to 28th Dec 2019
Facilitator - Dr. Sunita T of Patan Hospital
Sharada S, ANM, Pida HP
Ambika K, ANM, Gajuri PHC
Anju C, Staff Nurse, Dolbhanjyang School
Sarita R, ANM, Gajuri, PHC
Rama R, ANM, Pida HP
History Taking (present illness, mentrual history, obstetric history, contraceptive history, personal history, occupational history, family history)
Physical Examination (GC fair, conscious or unconscious, vitals, PILCCOD, breast & chest examination, cardiovascular, per abdomen, per speculum, per vaginal examination
Types of Discharge (Physical and pathological)
Sexually Transmitted Diseases (STD)
Disfunctional Uterine Bleeding (DUB)
Total 18 patients were asked to b subjects for the training.
Words from Dr. Sunita T (Facilitator):
The gynecological training conducted by Himalayan Health Care from 25th December to 28th December in Gajuri Rural Municipality, Dhading was initiated with the aim of training midwives (ANM/Staff Nurse) to improve quality and safety in women’s health. It was mainly focused on gynecological examinations (history taking and physical examination), identifying and treatment of common gynecological infections, management of abnormal uterine bleeding and uterine prolapse, screening methods such as VIA, PAP smear. Management of obstetrical conditions such as hyperemesis gravidarum, antepartum hemorrhage (APH), postpartum hemorrhage (PPH) were also discussed.
The trainees were enthusiastic, hardworking and actively participated in discussion and provided good patient care at the gynecological outpatient under supervision. They were comfortable in managing obstetrical patients but had confusions in managing gynecological patinets. Therefore, these kind of trainings should be held rgularly as it will help them in providing quality of care to the gynecological patients and improving the standard of care.
Words from Dr. Richa S (Facilitator):
We started with history taking and then went into discussions of diseases like vaginal discharge, sexually transmitted disease, pelvic inflammatory disease, dysfunctional uterine bleeding, etc., and a variety of cases were demonstrated to the trainees during the training sessions. The trainees had some knowledge about all that we discussed but we expanded on them to help them learn more. I believe that these types of trainings must be provided to all health workers working in remote areas so that the women patients will benefit greatly and they will also be more open to discussing their women problems.
The trainees had very little knowledge about vaginal discharge, types of discharge and treatment and we spent an entire day explaining about types of vaginal discharge, their cause and treatment. We kept the training sessions interactive throughout so that the trainees were submerged. We did demonstration on some patients who presented with vaginal discharge in the outpatient department. During the demonstration period the participants got to variety of cases and were able to determine what the case was. At the end of the training they were able to identify different kind of discharge cases and were able to provide treatment accordingly. I am happy with the training I was able to provide to these young women.