To further bridge the quality gaps in BEmONC, responsible stakeholders might need to consider tailoring competence based in-service short courses on priority maternal and neonatal conditions.
Courses that were verified to offer FP theoretical training and whose graduates were trained via hands-on skill practice with real clients were judged likely to offer a high level of competence in FP service and all the rest were judged to produce graduates with low levels of FP competence.
In 1997, in-service competence-based training was introduced to teach core clinical competences (such as care for normal birth, basic emergency obstetric and neonatal care and post-abortion care), to maternity care health providers, to support the Making Pregnancy Safer initiatives.
The test of typical performance can be achieved with ratings from faculty, peers, nurses, and patients to evaluate professionalism competence in regular clinical services.
While there is evidence of the need for pre-hospital practitioners maintaining competence in other ambulance services internationally e.g., Australia, UK and Canada, their guidelines are less prescriptive.
They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion.
However, we also believe that a higher level of specialist palliative care competence in the home care services and closer collaboration between these services and the hospital may reduce the need for emergency admissions.
In general, young clients are satisfied with the scope of services provided by the clinics and the competence of service providers in delivering their services in youth friendly ways.
Our findings indicate problems with pre-service education as well as with in-service training leading to poor competence and non-use of the partograph.
In-service training and mentoring to fill competence gaps of new graduates is also essential.
