HHC had discussion with the District Health Office in regards to expansion of the training to Benighat Rorang Rural Municipality after HHC was approaced for such a training. HHC had conducted similar training in Ruby Valley and Gajuri Rural Municipalities in 2019 and 2020. Benirorang RM also has health posts in isolated remote village sites and helping the midwives with gynecological training was a continuation of HHC’s support to this rural municipality as well as improving services to the women patients of the region.
Benighat Health Post where the training was conducted is three hours’ drive from Kathmandu and one hour from the Dhading District HQ of Dhadingbesi and is the center of the region but the participants had to travel for several hours and bus ride to reach this center from other village sites which are spread out in the region. HHC Officer Mr. Nabin M escorted the specialists from Kathmandu for the training. The training was held from 16 to 19 November, 2020 for 11 Auxiliary Nurse Midwives (ANMs). The trainees were diving into two groups and one was facilitated by Dr. Richa J and another one by Dr. Rakshya U. Both the trainees worked at Paropkar Indra Rajya Laxmi Maternity Hospital Thapathali, kathmandu. The chief consultant of Obstetrics and Gynecology of Paropakar Maternity and Women’s
Hospital, who helped HHC find the expert trainers, also decided to join the team and
observe the training for future support and while she was there provided training on the
First day of training: History taking, introduction, chief complaint, menstrual history, obstretic and contraseptic history, past or present medical history, occupational/family history etc.
Second day of training:
Types of vaginal discharge
1. Physiological- reproductive age, menstrual and hormonal
2. Pathological - infected and non-infected
Infected: Sexually infected- TV, Chlamydia, Gonorrhea, Syphilis, HSV Non sexual infected- BV,
Candida (mostly below 25 Years)
Non-infected: Foreign body, atrophic (dryness) and
3. Malignant Diseases
Major Causative Agent and Nature of Discharge:
1. Candida fungal agent with curdy discharge with itching
2. Bacterial vaginitis causes by chlamydia bacteria with grayish white discharge
3. Trichomonas protozoal agent with greenish discharge with frothy nature
4. Gonorrhea bacteria discharge Fishy odor
5. Syphilis bacterial ulcer on vagina
Third day of training:
Definition of PPH:
Types of PPH: Primary / Secondary
Estimation of blood loss
Management of PPH:
Pharmacological: Oxytocin, misoprostol, tranostat, mothering
Non Pharmacological: Aortic compression, uterine compression and condom tamponade
Identification and treatment of jaundice, fever, and kangaroo mother care
Fourth day of Training:
Participants were interested to know about hypertension complicating pregnancy.Therefore they were given basic information that would help in diagnosing it:
Chronic Hypertension with superimposed preeclampsia
Discussion on how to properly counsel patient, revision of previous day’s topics.
A total of 6 patients were checked while conducting practical training
During the closing program six officials of Benighat Rorang RM participated and thanked
HHC and the trainers for the effective training provided to the participants. The closing
ceremony was carried out ensuring Covid-19 protocols were followed.
Finally, the chairman handed out certificates and health check kits (table right) to all theAttachments:
participants provided by Himalayan HealthCare.