In February 2019, implementing partners in Nepal ran a three-day training workshop for the all-women team of 15 participants. These were service providers, including eight nurses, six midwives, and one physician. The workshop was led by an all-women team of clinicians comprised of one international lead facilitator and five local co-facilitators who were inducted beforehand to the learning resource package—these co-facilitators will help carry out future cascade trainings in other districts.
Overall, participants found the S-CORT on LARCs effective in refreshing their knowledge and skills. They reported a boost in their confidence in prioritizing family planning and LARC services even in humanitarian settings, stressing the importance of clinical readiness for such interventions.
Earlier, we provided services, but now we are also more focused on how to best provide services in emergency settings. Trainee
Many commented that it was their first exposure to the MISP and underlined the importance of offering SRH services even in humanitarian settings.
I feel very confident that I can provide the best service for my patients regardless of any disastrous situations. Trainee
Providers agreed on the effect of the training on how they would offer services, stressing the improvement of counseling as a distinct clinical take-away.
Before, balanced counseling was lacking, but after the training, I have started paying close attention to counseling, along with providing other medical services. I have started realizing the importance of counseling the patients before and after providing contraceptives like LARCs. Trainee
Rights and access
The training appears to have contributed to increasing the awareness and practice of rights-based service provision, such as systematically obtaining informed consent from clients. Ensuring the privacy and confidentiality of services was also a highlight.
I think one thing I would like to say about this training is that it has helped us enhance our performance as it has stressed the idea of patient privacy and confidentiality. Trainee
In their reflection about the geographical barriers inherent to the Nepalese terrain, especially in rural areas, providers understood the importance of expanding choice and ensuring access to LARCs for individuals displaced by crises.
Sometimes women have to walk five to seven hours to the campsites to receive contraceptives in rural areas of Nepal. So, it is even more important to provide them with LARC methods in order to minimize [the risk of] unwanted and unintended pregnancies. Trainee
Additionally, participants appeared to understand the need for adolescents to have equal access to a wide choice of contraceptives, including LARCs. In this respect, they underlined the need to appropriately counsel adolescents about LARCs, such as recommending a barrier method when needed to prevent sexually transmitted infections.
Overall, trainees and local trainers found the learning resource package user-friendly and balanced between interactive theory and practice.
The package is well organized, has handouts, checklists, is color-coded, and also has demonstration and practice sessions…Everything is readymade here. So easy for us, the right balance of materials. Trainer
Most participants and co-trainers recommended increasing the training to five days with a dedicated day for clinical practice. Instead of returning home every day after the training hours, a residential workshop would be a preferred option with the advantage of allowing more time for group learning and sharing.
If we are able to provide all the materials and equipment in a hotel setting and maybe if we are able to spend the night there, then we would not have to rush back home or rush back in the next morning. We would feel rather relaxed and also would be able to share experiences and learnings after the training session is over among all the participants. Trainee
However, several participants suggested that sharing a hardcopy of the learning materials in advance for self-study could be more time-efficient and allow further opportunities for clinical practice. Such an approach could help successfully keep the workshop to a three-day duration.
I think if we are given the materials in advance, then we can have a look at them and then further discuss it during the session for more efficiency and effectiveness. Trainee
Overall, there was agreement on the advantages of the training localization driven by the S-CORT outreach strategy.
On-the-job training is better. Better if we go there and do it in different districts. Then, participants don’t have to travel a long distance. Trainer