Accelerating Newborn Survival in Ghana Through a Low-dose, High-frequency Health Worker Training Approach

In-service training for skilled birth attendants (SBAs) is one of the most common interventions to address lack of knowledge and skills. However, these training interventions are seldom evaluated for effectiveness in improving learning or performance.

This study study is a cluster-randomized waitlist trial implemented in 40 public and mission hospitals in Ghana. It assesses the effect of a low-dose, high-frequency (LDHF) training approach to update hospital-based SBAs in key evidence-based intrapartum and immediate newborn care practices, using current global guidelines.The LDHF approach includes two 4-day onsite sessions (low dose) with weekly practice sessions, SMS quizzes and reminders, and mentoring via mobile phone and onsite visits between trainings (high frequency). The low-dose sessions include competency acquisition through simulation, case-based learning, and small content packages spread over short time intervals.

Eligible hospitals will be stratified by geographic region and caseload, and then randomly assigned to one of four implementation waves. The pipeline randomization allows for rigorous evaluation while the program is rolled out to all facilities.

Inclusion criteria

- FACILITIES:

• Public or faith based hospital
• At least three skilled birth attendants on staff
• At least 30 births per month

Exclusion criteria

- FACILITIES:

• Private hospital
• Public or faith based hospital with less than three skilled birth attendants on staff
• Public or faith based hospital with less than 30 births per month

Inclusion criteria

- SERVICE PROVIDERS:

• Health providers who attend births in participating health facilities and consent to be assessed at the time of enrollment and at several points in time over the study period

Exclusion criteria

- SERVICE PROVIDERS:

• Health providers who decline to participate