This paper describes the degree to which community volunteers’ knowledge and skills were retained 18 months after the initial training.
We used a before-after design to assess pre-, post- and post-post-training retention of essential steps of care during pregnancy, birth and after birth. Maternal and Newborn Health Specialists assessed demonstrated knowledge using structured observation, skills checklists and role-play (simulation). Of 541 volunteers who were trained, all were participated in the pre- and post-training skills assessment while 157 of them took part in post-post assessment. Paired t-test was computed to compare mean differences in pre- and post-test as well as post-and post-post-training scores (average % of steps completed out of total possible steps).
Post training performance scores were significantly higher than immediate pre-training scores for all care steps including counseling to take iron and adherence (1.4% versus 66%, P<0.001), counseling on feeding practice during pregnancy, early initiation of breast feeding, exclusive breast feeding and positioning and attachment (12% versus 81%, 7% versus 87%, 2% versus 78%, and 3% versus 56%, all p<0.001). We also observed significantly higher post-post-scores compared to post-test scores in counseling pregnant women to eat iron and calcium rich foods (78% versus 89% and 84% versus 94%, p<0.01) and counseling postpartum women on breast feeding (65% versus 74%, p< 0.05) after birth.
Community volunteers were able to retain essential maternal and newborn health and nutrition knowledge and skills over time, most likely because they used these continuously in conducting the CMNH Family Meetings.