What we learned

Interventions to improve the status of maternal and newborn health must be relevant, cost-efficient, and sustainable. During the 50,000 Happy Birthdays project we learnt what works well and could be integrated into future programming, to enable sustainable impact.

Project design: tips for success

Include multidisciplinary healthcare providers

Projects benefit from having a multidisciplinary team in the planning, training, LDHF practice sessions and ongoing monitoring and evaluation of activities.

Improved teamwork and communication between invested healthcare providers results in better understanding of each other’s role and coordinated care provision.

Including in-service health facilities and pre-service educational institutions helps align best practice between clinicians and students.

Support the in-country teams

Ensure sufficient resources to support the teams before starting training activities and frequently during implementation (West, 2017).

Provide additional support to midwifery educators integrating new methods of teaching into existing curricula.

Provide help to set realistic and achievable goals, establish communication and feedback mechanisms, conduct needs assessments, and develop a costed activity plan with target numbers of implementation sites and individuals.

Ensure access to training resources and clinical equipment

To make sure training activities happen on time, resources/equipment must be calculated, procured, shipped and distributed before the project implementation phase.

Ensure sufficient resources to support the teams before starting training activities and frequently during implementation (West, 2017).

Build a strong project team

Rely on an international team with cultural competence and experience working to support projects remotely.

Adequate compensation and resources for the national teams are essential to lead the project.

Recruit Master Trainers and Practice Coordinators with recent clinical and education experience, who are enthusiastic and focused on improving health outcomes.

Align with existing national initiatives for increased scope

National mentorship or supervision program staff are good advocates for HMS and HBS training and quality improvement.

National HMIS departments provide relevant context to guide the development of monitoring and evaluation frameworks.

Early on, consult with other health professional associations, NGO and private sector stakeholders to align activities and share resources.

Support sustainable quality training

Identify and address barriers to quality, facility-based cascade training, and LDHF practice sessions. Consider that environments with a depleted health workforce may take more time to train.

Providing practice coordinators at implementation sites with financial incentives and tools enables communication and data collection.

Give priority to quality

Digitalising the data collection tools to increase the quality improvement feedback loop between project manager and implementation sites.

Prioritise the quality of the training given the context, time frame and budget constraints. Consider training more people in fewer modules, or fewer people in more modules.

“The project has the potential to bring about widespread improvements to quality of care if the investment can be sustained and expanded.”

(Novametrics, 2020)