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Table 1 HMS BAB Training Intervention description using the four constructs of the i-PARIHS

From: Health workers’ experiences of implementation of Helping Mothers Survive Bleeding after Birth training in Tanzania: a process evaluation using the i-PARIHS framework

Construct

Description of the construct in the HMS BAB training intervention

Innovation

Competency-based in-facility training, use low-fidelity birthing simulator: Mama Natalie. Inclusive to all maternity-ward staff (multi-profession)

Training curriculum covers communication with pregnant woman and family, standard delivery, Active Management of Third Stage of Labour (AMTSL), assessment of excessive bleeding, care of newborn, and preparation of advanced/referral care when needed

Graphic flip chart, learner’s guide, posters

Facilitation

Short theory sessions followed by role plays, case scenarios and skill practice on the Mama Natalie simulator. Practice sessions are followed by debriefing and group discussions. Some training materials were available in local language, Kiswahili

Outside/district facilitators- pairs of outside facilitators conducted initial in-facility training in all the facilities, they identified and coached local facilitators or “peer practice coordinators.”

The “peer practice coordinators” organised colleagues for short weekly practice drills on PPH-specific scenarios

The Recipients

All maternity ward health workers of different cadres trained on the initial day, used the knowledge and skills gained and continued to practice with simulators

Context

Training is in-facility, using the local environment and managing everyday daily tasks and creating safe learning and regular practice sessions at the workplace