I have attended all the IHLFS training: one course in 2010, two in 2011 and two in 2012. I received two prizes: one for my presentation on eclampsia and one on malnutrition. The CHOs were responsible for training the MCHAs on the last course, which was a good thing because I love to teach. The MCHAs at PHUs are seeing the pregnant women and under 5s; they can pick up any problems promptly and tell CHOs of the problems.
MCHAs in Kambia graduate with limited practical skills, so they lack the real skills to resucitate babies, which is why this training is so important and needed. From the Kambia Appeal training, MCHAs now get practical training and the infant mortality rate has dropped because MCHAs now know how to resuscitate babies. The donation of basic medical equipment, like the Ambu bags has also helped.
I have seen that the maternal mortality rate has dropped significantly. This is a result of the improvement of health worker skills - particularly MCHAs and CHOs and the vacuum extraction kits (infants used to in utero), but this new equipment can ave the lives of the babies and the mothers.
Free healthcare for mothers and babies is making a very positive difference, especially for women needing c-sections, but the free drugs are not always available at PHUs.
There is a problem with reporting maternal death. There is an under-reporting of deaths in the community, but at PHUs maternal deaths are being reported. At Yelibuya Island PHU (where I worked previously) there were no maternal deaths under my care. Improved training is making antenatal clinics more effective in identifying problems during pregnancy earlier. I can keep a close eye on pregnant women if they attend my antenatal clinics.