Embedded care nurse programs are increasingly recognized for their crucial role in enhancing maternal and child health outcomes, particularly in resource-limited settings. These programs, designed to integrate within existing healthcare systems, focus on improving the quality of care through targeted training and mentorship. One such impactful initiative is the Apatkaleen Matritva evam Navjat Tatparta (AMANAT) program in Bihar, India, which serves as a compelling example of an embedded care nurse program in action. Understanding the components of such programs is vital for effective implementation and replication in similar contexts.
The AMANAT program, facilitated by CARE-India in collaboration with the Government of Bihar, strategically incorporates several key components to achieve its goals. At its core is a comprehensive nurse-mentoring approach. This involves experienced nurses providing ongoing guidance and support to their colleagues directly within healthcare facilities. This embedded mentorship model ensures that training is not a one-time event but a continuous process, allowing for sustained improvement in clinical practices.
A significant component of the AMANAT program is simulation and team-training, delivered in partnership with PRONTO International. These simulations are designed to enhance both technical and non-technical skills essential for managing obstetric and neonatal emergencies. By creating realistic scenarios, nurses can practice critical procedures and improve their responses to various clinical situations. The emphasis on team-training further strengthens communication and collaboration among healthcare providers, which is crucial for effective emergency response and patient care. Specifically, simulations cover a range of conditions encountered in basic emergency obstetric and neonatal care (BEmONC) facilities, ensuring that nurses are well-prepared to handle common and critical cases.
The effectiveness of these components is evident from a study conducted across 320 BEmONC facilities in Bihar. The study, which observed deliveries before and after the implementation of the AMANAT program, revealed substantial improvements in both intrapartum and newborn care practices. Facility-level scores for intrapartum care improved by 37 percentage points, and newborn care scores increased by 26 percentage points. These results strongly suggest that the combination of nurse-mentoring, simulation, and team-training is highly effective in enhancing the quality of care provided in these facilities. Furthermore, the study highlighted that facilities with higher participation in simulations demonstrated even greater improvements in care scores, underscoring the importance of active engagement in these training activities.
In conclusion, the embedded care nurse program, exemplified by the AMANAT initiative, comprises crucial components such as continuous nurse-mentoring, simulation-based training, and a focus on team dynamics. These elements work synergistically to enhance the skills and preparedness of nurses, leading to significant improvements in maternal and newborn health outcomes within public health facilities. The success of the AMANAT program provides valuable insights into the design and implementation of effective embedded care nurse programs globally, particularly in settings striving to strengthen their healthcare systems and improve maternal and child health.
