Another key issue is the extent to which competence in skilled birth attendance is difficult to assess across the case-study countries.
This indicates a lack of standardization in the delivery of meat inspection service as reflected by the difference in the number and competence of skilled workers.
As the importance of faculty development in PBL was valued by participants in the forum discussion this may suggest more facilitator development workshops to help achieve competence as skilled facilitators of the PBL process.
In an attempt to reduce maternal mortality and morbidity, global efforts have been directed towards increasing access to quality maternal health care services by increasing the number and competence of skilled birth attendants (SBAs) [ 1- 3].
There are particular difficulties in this assessment in Zambia, where no separate category of midwife exists and where nurses are not all trained to an adequate level of competence in skilled birth attendance; and in Sierra Leone where Maternal Child Health (MCH) aides do not meet the international definition of SBA but are locally expected to play this role.
They were also more likely to want to volunteer after reading the social connection words than after reading words that evoked autonomy (e.g., freedom, choice, preference) or competence (e.g., skilled, expert, competent).
This is consistent with one recent qualitative study in Cambodia, which reported that women's perception of the limited midwifery competences of skilled birth attendants at health centres undermined their decision and willingness to access and use services [ 33].
Skilled users of AAC show communicative competence in four interrelated areas: linguistic, operational, social and strategic.
One way to assist with your circle of competence is to bring in skilled and/or local partners.
Three main themes emerged: 1) the lack of competence and clinical skill; 2) cultural beliefs and low participation of family in antenatal care programme; 3) insufficient facilities and skilled support staff in Public Health Centres.
"There is a particularly large deficit of engineers, IT-skilled professionals, and other workers with digital competence," said Andreas Hatzigeorgiou.
