CLINICAL TRAINING for Family REPRODUCTIVE HEALTH in ...

CLINICAL TRAINING for REPRODUCTIVE HEALTH

in EMERGENCIES

Family Planning

TRAINER GUIDE

CLINICAL TRAINING for REPRODUCTIVE HEALTH

in EMERGENCIES

Family Planning

TRAINER GUIDE

ACKNOWLEDGEMENTS

The Reproductive Health Access, Information and Services in Emergencies (RAISE) Initiative has developed a Family Planning Learning Resource Package for training service providers in emergency settings with contributions from many key individuals, without whom these manuals would not have been possible. RAISE would like to acknowledge with gratitude the many skilled professionals who developed this package including: Dr. Fred Akonde, Dr. Grace Kodindo, Pamela Ochieng, Louise Lee-Jones, Emma Simpson, Dr. Kathleen Mitchell and the Medical Development Team of Marie Stopes International. Those who worked on earlier versions of this guide are gratefully acknowledged, in particular from Jhpiego, United Nations Population Fund (UNFPA), Government of Kenya, Ministry of Health, University of Nairobi and the Kenyatta National Hospital.

RAISE Initiative. Family Planning: Trainer Guide. Clinical Training for Reproductive Health in Emergencies. Reproductive Health Access Information and Services in Emergencies Initiative. London, Nairobi and New York, 2009. Design and production: Green Communication Design inc. greencom.ca

TABLE OF CONTENTS

ACRONYMS

3

INTRODUCTION

4

INTRODUCTION TO THIS TRAINING COURSE

5

5 OV ERVIE W

5 LEARNING APPROACH 5 Mastery learning 6 Behaviour modelling 6 Competency-based training 6 Humanistic training techniques

7 LEARNING METHODS 7 Illustrated lectures 7 Group activities 7 Case studies 7 Learning guides and checklists

COMPONENTS OF THE FAMILY PLANNING (FP) LEARNING RESOURCE PACKAGE 10

USING THE FP LEARNING RESOURCE PACKAGE TO TRAIN SERVICE PROVIDERS IN EMERGENCY 10 SETTINGS

11 COURSE DESIGN

11 EVALUATION

12 COURSE SYLLABUS 12 Course description 12 Course goals 12 Participant learning objectives 12 Training and learning methods 12 Training materials 12 Reference material 13 Selection criteria for participants 13 Suggested class size 13 Course duration 14 Course schedule

PARTICIPANT GUIDELINES FOR SELF-DIRECTED 16 PRACTICUM 16 Participant responsibilities 16 Team responsibilities 16 Documenting activities

17 KNOWLEDGE QUESTIONNAIRES

FAMILY PLANNING KNOWLEDGE 18 QUESTIONNAIRE

FAMILY PLANNING KNOWLEDGE QUESTIONNAIRE ? ANSWER KEY 21

FAMILY PLANNING COURSE INDIVIDUAL AND GROUP ASSESSMENT MATRIX24

SKILLS PRACTISE SESSIONS: LEARNING GUIDES AND CHECKLISTS

27

1 SKILLS PRACTISE SESSION: FAMILY PLANNING COUNSELLING

27

1. LEARNING GUIDE FOR FAMILY PLANNING 28 COUNSELLING

1. CHECKLIST FOR FAMILY PLANNING COUNSELLING 31

2 SKILLS PRACTISE SESSION: HISTORY TAKING

33

34 2. LEARNING GUIDE FOR HISTORY TAKING

37 2. CHECKLIST FOR HISTORY TAKING

3 SKILLS PRACTISE SESSION: PHYSICAL EXAMINATION

39

3. LEARNING GUIDE FOR PHYSICAL EXAMINATION 40

3. CHECKLIST FOR PHYSICAL 43 EXAMINATION

4 SKILLS PRACTISE SESSION: MALE AND FEMALE CONDOMS

45

4. LEARNING GUIDE FOR MALE AND FEMALE 46 CONDOMS

4. CHECKLIST FOR MALE AND FEMALE 48 CONDOMS

TRAINER GUIDE 1

TABLE OF CONTENTS (cont'd)

5 SKILLS PRACTISE SESSION: COMBINED ORAL CONTRACEPTIVES

49

5. LEARNING GUIDE FOR COMBINED ORAL 50 CONTRACEPTIVES

5. CHECKLIST FOR COMBINED ORAL 52 CONTRACEPTIVES

6 SKILLS PRACTISE SESSION: PROGESTIN-ONLY PILLS

53

6. LEARNING GUIDE FOR PROGESTIN-ONLY 54 PILL

56 6. CHECKLIST FOR PROGESTIN-ONLY PILL

7 SKILLS PRACTISE SESSION: PROGESTIN-INJECTABLE CONTRACEPTIVES

57

7. LEARNING GUIDE FOR PROGESTIN-INJECTABLE CONTRACEP 58 TIVES

7. CHECKLIST FOR PROGESTIN-INJECTABLE 60 CONTRACEPTIVES

8 SKILLS PRACTISE SESSION: IMPLANT CONTRACEPTION

61

8a. LEARNING GUIDE FOR IMPLANT CONTRACEPTION 62 INSERTION

8a. CHECKLIST FOR IMPLANT CONTRACEPTION 65 INSERTION

8b. LEARNING GUIDE FOR IMPLANT CONTRACEPTION 67 REMOVAL 8b. CHECKLIST FOR IMPLANT CONTRACEPTION 69 REMOVAL

9 SKILLS PRACTISE SESSION: INTRA-UTERINE DEVICE (IUD)

71

9a. LEARNING GUIDE FOR INTRA-UTERINE DEVICE (IUD) 72 INSERTION

9a. CHECKLIST FOR INTRA-UTERINE DEVICE (IUD) 75 INSERTION

9b. LEARNING GUIDE FOR INTRA-UTERINE DEVICE (IUD) REMOVAL 77 9b. CHECKLIST FOR INTRA-UTERINE DEVICE (IUD) 78 REMOVAL

CASE STUDIES

79

1 79 CASE STUDY

2 80 CASE STUDY

3 81 CASE STUDY

4 82 CASE STUDY

TIPS FOR TRAINERS

83

83 BEING AN EFFECTIVE CLINICAL TRAINER

CHARACTERISTICS OF AN EFFECTIVE TRAINER AND 83 COACH

SKILL TRANSFER AND ASSESSMENT: THE COACHING 84 PROCESS

CREATING A POSITIVE LEARNING 84 ENVIRONMENT

84 PREPARING FOR THE COURSE

85 UNDERSTANDING HOW PEOPLE LEARN

USING EFFECTIVE PRESENTATION SKILLS 87

88 CONDUCTING LEARNING ACTIVITIES

DELIVERING INTERACTIVE 88 PRESENTATIONS

90 FACILITATING GROUP DISCUSSIONS

FACILITATING A BRAINSTORMING SESSION 91

FACILITATING SMALL GROUP ACTIVITIES 91

CONDUCTING AN EFFECTIVE CLINICAL 92 DEMONSTRATION

TEACHING CLINICAL DECISION-MAKING 93

94 MANAGING CLINICAL PRACTICE

PERFORMING CLINICAL PROCEDURES WITH 95 CLIENTS

CREATING OPPORTUNITIES FOR LEARNING 95

CONDUCTING PRE- AND POST-CLINICAL PRACTICE MEETINGS 97

97 THE TRAINER AS SUPERVISOR

98 THE TRAINER AS COACH

REFERENCE GUIDE

101

2 Family Planning

ACRONYMS

AIDS

ANC ART ARV CBT CDC

CIC

COC CVA DMPA

DVT EC ECP

FGM FP HGC

HIV

HLD IDP IEC

IHD IP

Acquired immunodeficiency syndrome Ante-natal care Anti-retroviral therapy Anti-retroviral Competency-based training Centers for Disease Control and Prevention Combined injectable contraceptive Combined oral contraceptive Cardiovascular accident Depo-Provera, Depo, Megestron and Petogen Deep-vein thrombosis Emergency contraception Emergency contraception pill Female genital mutilation Family planning Human chorionic gonadotrophin Human immunodeficiency virus High-level disinfection Internally displaced person Information, education and communication Ischaemic heartdisease Infection prevention

IPCC Interpersonal communication and counselling

IUD Intra-uterine device LAM Lactational

amenorrhoea method LNG Levonorgestrel MCH Maternal and child health MVA Manual vacuum aspiration NET-EN Noristerat and syngestal PAC Post-abortion care PE Pulmonary embolism PIC Progestin-only injectable

contraceptive PITC Provider-initiated counselling

and testing PNC Post-natal care POP Progestin-only pill PPE Personal protective

equipment RH Reproductive health RTI Respiratory tract infection SDP Service delivery point STI Sexually-transmitted

infection TL Tubal ligation VCT Voluntary counselling

and testing VSC Voluntary surgical

contraception WHO World Health Organisation

TRAINER GUIDE 3

INTRODUCTION

The rights of displaced people to reproductive health (RH) were recognised at the International Conference on Population and Development in 1994. Since then, RH service provision has progressed, but substantial gaps remain in services, institutional capacity, policy and funding. It has been shown that provision of emergency obstetric care, clinical family planning methods, care for survivors of gender-based violence and management of sexually-transmitted infections (STIs) is lacking in most conflict-affected settings. One of the key barriers to the provision of comprehensive RH services is the lack of skilled providers. In order to address this, RAISE has developed a comprehensive training package, including training centres and course manuals. The clinical training teams provide theoretical and practical training to RH service providers at the training centres, as well as on-site supervision at the participants' workplace and on-going technical assistance. Providing clinical training to humanitarian agency and ministry of health staff from a range of conflict settings, the RAISE training team aims to improve the quality of care of RH services in conflict settings. The resources in the Clinical Training for Reproductive Health in Emergencies series are based on existing materials and have been updated and adapted for use in emergency settings. All manuals have been pre-tested at the RAISE Training Centre at Eastleigh Maternity Home in Nairobi. Many procedures and protocols remain unchanged from non-emergency settings. However, in some instances it is necessary to adapt a protocol to recognise the particular challenges faced in emergency settings. The Family Planning (FP) learning resource package comprises materials and supervised clinical practise. The materials are: ## trainer guide and reference manual (for the trainer) ## participant guide and reference manual (for the training participant)

4 Family Planning

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