健康教育研究開発ジャーナル

Uptake of Training on Vscan by Midlevel Providers Working in Rural Health Facilities in Tanzania: Implications for Reliability

Abstract

Selemani Mbuyita, Robert Tillya, Ritha Godfrey, Uzzell Janeen, Kallol Mukherji,Amon Exavery, Godfrey Mbaruku

For decades now maternal mortality has remained high especially in developing countries. Reasons for these deaths are many but mainly due to health system failures such as critical shortages of health work force and limited use of appropriate technologies in service rendering among others.

New innovations are produced to reduce maternal mortality. One such innovation is the use of a hand held portable ultrasound called Vscan. However, while the Vscan is simplified to suit different contexts, availability of experts to manage and conduct scanning in rural health facilities is limited. Training of the available non clinician and midlevel health providers is one of the available options.

We conducted a study to ascertain if midlevel health providers working in rural settings in Tanzania can be trained and provide ultrasound scanning services using the Vscan in routine antenatal clinics.

We used a mix of training methods including presentations, lectures, group discussions, demonstration and hands on sessions to conduct the study.

Results showed that, despite the technology being sophisticated, the uptake of knowledge by the trainees was strongly satisfactory. Using the pre and post-tests method, there was a significant change in knowledge of the trainees when comparing their basic knowledge on radiology, sonology and pregnancy related complication detection and diagnosis that they had before training and after training. On the other hand, no statistical significant difference was noted in knowledge uptake and translating the knowledge in practice between the different cadres of the midlevel providers involved in the training. The quality of scanning using the Vscan between the trainees and those of expert sonologists was 77% compatible.

The study concludes that, it is possible to train health providers to conduct routine scanning using Vscan at primary health facility level and produce quality scans and correct diagnosis similar to that of expert sonologist.