Considerable investments have been made in developing capacity of health staff through national training initiatives in Timor-Leste, but significant gaps remain. HAI and other health partners have supported the Timor-Leste National Institute for Health (INS) to conduct national in-service and refresher training across the maternal care continuum. With USAID and Australian Government funding, HAI’s staff of midwife trainers have supported national training for municipality midwives in essential newborn care, safe and clean delivery and family planning, and also supported refresher training for basic emergency obstetric care.
After large national training efforts, a coordinated system of follow-up-after-training (FUAT) and supportive supervision for quality improvement is needed. To address the ‘FUAT gap,’ HAI in partnership with INS developed and implemented an innovative approach we call Learning Labs. These are a cost-effective and practical way of developing health provider core competencies, improving provider-client communication, and strengthening provider motivation. Facilitated monthly for six months in the midwives’ own health facilities, adult learning approaches are applied through use of case-studies, practice simulations, and role plays. The Learning Lab is underpinned by the principles of adult learning, engaging with the trainee through a respectful, professional, and caring attitude to enhance a supportive learning environment. Addressing issues of domestic violence and the needs of women with disability have been incorporated into the Learning Lab model.
An evaluation of the Essential Newborn Care Learning Lab indicated that all the providers who participated in Learning Labs achieved competency or proficiency after six months, compared to none in the control site. Following this successful evaluation, a Learning Lab was developed for Safe and Clean Delivery Care, where the evaluation similarly showed that midwives who participated in Learning Labs achieved competency or proficiency of skills as compared to sub-optimal competency levels pre-intervention.