A Training of Trainers
An important aspect of our development work in the Central Highlands is our Birth and Life Saving Skills (BLiSS) course, which uses participatory adult education techniques to facilitate conversation about safe pregnancies, deliveries, and newborn care. Our aim is to eliminate unsafe traditional practices and combine healthy traditional beliefs with safe midwifery practices.
Last autumn, our own BLiSS team gathered 17 men and 24 women from a selection of villages in the Central Highlands to train them as BLiSS trainers for their own villages. While we have been involved in training trainers for a number of years, this year was set apart as the first year that our own team provided the training on their own. Over the course of eight days, participants learned the entire BLiSS and nutrition curriculum in order to return to their own villages and teach it there.
What is BLiSS all about?
The BLiSS course is made up of a series of lessons that cover pre and post-natal health, as well as information on things that can go wrong during pregnancy, birth, or after birth. There is discussion on what can be done for proactive health during pregnancy, child birth, and after a child is born, as well as what can be done should difficulties occur. An additional section on nutrition provides participants with further knowledge on a healthy first year for their newborns. When participants finish the course, they are armed with knowledge and skills to prevent issues as much as possible, care for one another should issues arise, and know the warning signs of bigger issues so they can head to a hospital quickly.
Why is it important?
Afghanistan has a high rate of maternal and infant mortality, and while this number has lessened over the years, there is still room for improvement. One of the largest difficulties for many people in rural areas is a lack of access to health care facilities. In the midst of a pregnancy or while a woman is labouring, making a long journey over bumpy roads to an adequate health care facility can be risky, and sometimes even fatal. By providing participants with knowledge to be proactive with preventable issues, the tools to help with some difficulties and know sooner when to get help for other difficulties, we can increase accessibility to basic interventions in villages and increase the likelihood that women and children having more complicated issues can get to an appropriate health care centre in time.
Training Local Teachers
The BLiSS course was created by Operation Mercy, another NGO in Afghanistan, and applied to our community development programme in 2009. At that time, a small group of our own facilitators received training from Operation Mercy and began carrying out the BLiSS course in our target areas in the Central Highlands. The training was not only applicable and well received by those who attended but was also quite literally life-changing. Villagers were able to see issues sooner and either get the appropriate help as soon as possible or help one another out. Men began saving money should issues health-issues arise, so their wives could be properly taken care of. A better understanding of how to be proactive against health issues enabled women to take care of themselves, and therefore their babies, during pregnancy. Families who had lost many children during pregnancy or child birth were finally having happy, healthy babies.
Our team knew that this course was making big differences. A problem still remained, however–the area in which we worked was large, with long distances between remote villages. Access to the villages in winter months also proved challenging, with lack of safe roads and the threat of avalanches. And yet, these remote villages were the ones that needed the BLiSS training most.
The Solution
Our team came up with a plan: we could ask for men and women from villages within the target areas to be trained as trainers themselves! During the courses, our team could still go out for key lessons and monitor, but not having to go out to each of these villages every day for a lesson would allow us to have a far wider reach. In addition, having trained men and women within the communities would allow an element of increased sustainability to the course–there would continue to be a source of knowledge in the community even after the official course was finished. With the thought of these promising advantages, we went ahead with the plan! In 2012, we invited BLiSS trainers from Operation Mercy to come out and train a group of women, who then returned to their villages to conduct the courses themselves. It was also in 2012 that a few of the men on our team also began to give men’s BLiSS courses in the winter months, so husbands could also help their wives if difficulties arose. Operation Mercy commented that “training local teachers has proven to be an effective method of expanding the reach of the important messages of BLiSS, in an area which is isolated and difficult to access.” The skills and knowledge provided through BLiSS
What makes this year different?
Six years later, our BLiSS course continues to reach more remote villages, and we continue to have a training of trainers each year, now with women and men who then return to teach their own communities. This year, however, was the first time that our BLiSS team gave the training without external support. Last year, trainers came in from the city and observed our team as they conducted the training of trainers. The Operation Mercy trainers commented that by our BLiSS team teaching in the local dialect and being aware of the local culture, participants were able to better engage and understand the course content. Operation Mercy sees our BLiSS facilitator team as both capable and qualified and were confident they could carry out the training themselves.
It is because of the training of trainers that the effects of BLiSS will spread to another 26 remote villages this winter. Despite living far away from medical care, they can be prepared and confident about facing issues of pregnancy and childbirth.
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