Effect of Comprehensive Training Package of National Health Programs on Knowledge and Skills of Auxiliary Nurse Midwives in Haryana, India.

INTRODUCTION

Auxiliary nurse midwives (ANMs), a key cadre within India's National Health Programs (NHPs). However, gaps in training, particularly in practical application, limit their effectiveness. This study evaluates the impact of a comprehensive training package on the knowledge and skills of ANMs in Haryana, India.

METHODOLOGY: A quasi-experimental pre-post design with no control group was conducted among 250 ANMs across 149 subcenters in Ambala and Panchkula districts, Haryana. A universal sampling method was used. Data collection included a self-administered questionnaire (SAQ) and an objective structured clinical examination (OSCE) checklist to assess knowledge and skills. A training intervention consisting of a modular training package and video demonstrations was implemented. Data analysis involved paired t-tests and multivariate regression to evaluate changes in knowledge and skill scores.

RESULTS

Baseline data revealed significant knowledge gaps, particularly in mental health and tobacco control. Following the training, knowledge scores improved by 46% and skill scores by 37% (P < 0.0001). Notable skill improvements were observed in areas, such as pregnancy detection, blood pressure measurement, newborn resuscitation, and ORS preparation at home, with most ANMs shifting from the poor/average categories to the good category (>70% score). The greatest overall gains were seen in the National Tuberculosis Elimination Program (NTEP) and Reproductive Maternal and Child Health (RMNCH + A). Factors positively influencing knowledge scores included working alongside a second ANM and receiving the training intervention (P < 0.05). However, a decline was noted in certain skills, such as tetanus toxoid (TT) administration, highlighting the need for targeted refresher training.

CONCLUSION

A structured, job-oriented training package significantly enhances ANMs' competencies. Integrating practical, hands-on training with existing theoretical models is essential for improving public health outcomes. Policymakers should prioritize periodic refresher training and comprehensive capacity-building strategies to optimize the impact of trainings on ANMs.