MCSP Lao PDR Quarterly Report FY 2018 Quarter 1

The MoH has achieved ambitious targets for increasing the number of skilled birth attendants in the country, but the quality of birth attendants is inadequate due to rapid education and lack of support and supervision post-training. In 2016, the MoH launched the Lao PDR Ministry of Health (2016) National Reproductive, Maternal, Newborn and Child Health Strategy and Action Plan 2016-2020, and the Lao PDR Ministry of Health (2016) Midwifery Improvement Plan 2016-2020. These plans recognize the need to develop capacity among midwives and maternal and newborn healthcare providers in Laos. The MoH has also introduced Early Essential Newborn care (EENC) in many provinces, including Luang Prabang and Sayaboury. MCSP Lao is supporting the MoH at the central and provincial levels to promote the introduction of capacity building and quality improvement approaches in 10 districts in Luang Prabang and Sayaboury provinces. The program aims to improve the quality of maternal and newborn care by strengthening key skills for maternal and newborn care among MNH care providers, their educators, and their supervisors. MCSP conducted 12 quarterly mentoring visits to district and provincial facilities in Sayaboury and Luang Prabang provinces. The districts selected and invited 5 midwives from 5 different health centers in each district to join the mentoring activities. This marked a key step as MCSP expands mentoring to health centers. The objective of each mentoring visit is to provide on-site support to district mentors with one mentor from the province (buddy support) and to begin mentoring health center midwives. Between October and December, health center mentees demonstrated improved confidence. The on-site visits by district mentors made a considerable difference in this area, highlighting the importance of on-site hands-on skills practice that focuses on select skills exemplifying the low-dose high-frequency approach to mentoring. In some districts, for example Nambak, the health center mentees were far better than the district level staff. This finding demonstrates the need to consider methods to enhance mentoring efforts to ensure that the district mentees maintain their skills as the program expands to the health centers and health center midwives. MCSP also supported the MoH initiative to strengthen supportive supervision of midwives with technical contributions to the national supportive supervision system and tools. District mentors led follow-up visits to health centers to do on-site mentoring with the midwives in health centers. These visits provide an opportunity for mentors to directly support mentees. Following the mentor meeting held in October, MCSP asked mentors to follow-up with health center midwives, encouraging them to integrate the visits with supervision team visits. Almost all of the districts were able to follow up and provide on-site mentoring to midwives in the health centers. The program has made significant progress in improving the quality of maternal and newborn care in Luang Prabang and Sayaboury provinces. The mentoring visits have improved the confidence of health center mentees, and the follow-up visits have provided an opportunity for mentors to directly support mentees. The program aims to continue supporting the MoH initiative to strengthen supportive supervision of midwives and to promote the introduction of capacity building and quality improvement approaches in 10 districts in Luang Prabang and Sayaboury provinces.