PPHI SINDH - Karachi

To ensure a competent, professional, and well-prepared healthcare workforce, training and capacity building are essential. It is vital for strengthening patient care, boosting the effectiveness of the health system, fostering innovation, addressing health disparities, and developing capable leadership and management abilities. To provide high-quality healthcare service delivery to the people, PPHI Sindh has established Training and Capacity Building wing.

In the first phase, Training of Trainers (ToT) will be conducted by professionals and highly skilled personnel. Building capacity of master trainers typically involves a more in-depth and comprehensive program that focuses on building advanced knowledge and skills in a particular area of healthcare.

After being trained, master trainers can share their expertise and abilities with medics and paramedics through structured training programs. Workshops, seminars, hands-on training, and other instructional approaches customized to the needs of the target audience may be used. The master trainers may also continue to support and mentor medics and paramedics as they use their newly gained knowledge and abilities in clinical practice. An Annual Training Plan have been developed by T & CB wing and after approval formal approval, the same is implemented to train technical staff at all levels. The trainings at PPHI Sindh are well planned, target oriented, focused, and well designed to keep the staff up to date.

•   Labour care guide (Revised Partograph)
•   Pregnancy, Childbirth, Postpartum & Newborn care (PCPNC)
•   Managing complications in pregnancy & Child Birth (MCPC)
•   Kangaroo Mother Care (KMC)
•   Family Planning
•   Maternal Death audit Form
•   Infection prevention & Control
•   Laboratory investigations
•   General Diseases Module (GDM)
•   Infectious and communicable diseases
•   Integrated Disease Surveillance & Response (IDSR)
•   Minimum Initial Service Package (MISP)
•   HPCP (Hepatitis case management Diagnostic/Referral )
•   CMAM guidelines

Quality of Care

The PPHI health facilities in Sindh, Pakistan have been facing challenges in delivering quality services to patients. The MCHIP/Jhpiego analysis revealed poor quality of care at these health facilities. To address this issue, a technical and management team has been established at the district level to improve the quality of care services provided by healthcare providers.

The team has implemented several interventions to improve the quality of services, including a facility quality audit, which is conducted quarterly by an identified person, most likely the facility in charge. The audit process utilizes a standard checklist for every maternal, newborn, and child health (MNCH) service, and scores are given in each area. Rewards are given to those who perform well, and pay for performance and contract renewal are linked to performance criteria since last year to further improve individual performance and the quality of care.

PPHI Sindh aims to achieve ISO certification for its centers in the long run. Therefore, the organization requires support to train its team in quality improvement (QI) and implement quality of care strategies at health facilities to achieve ISO certification, which would be the first-ever for primary healthcare facilities in Pakistan.

More than 600 PPHI health facilities are registered with the Sindh Healthcare Commission and are planning to adopt the quality of care process to receive quality certification from SHCC soon. By implementing these interventions and pursuing ISO certification, PPHI is taking a significant step towards improving the quality of care and ensuring better health outcomes for the people of Sindh, Pakistan.

Evidence based Practices in MNCH

In order to contribute to the reduction of maternal, newborn, and child health mortality, PPHI Sindh has implemented a range of evidence-based practices and trained healthcare providers in health facilities throughout the province. Many of these practices were introduced for the first time in Sindh, and they have had a significant impact on improving health outcomes for mothers and children.

For example, to reduce the burden of postpartum hemorrhage (PPH), PPHI Sindh introduced the advanced antenatal distribution of misoprostol. In addition, infection prevention protocols were instituted in every facility to decrease puerperal sepsis. To increase facility-based delivery, 24/7 BHU Plus provides MNCH services. For managing eclampsia, magnesium sulfate was made available at all health facilities.

Skills of Health Care Providers

Improving the skills of healthcare professionals in accurately diagnosing and treating patients remains a major challenge in the healthcare industry. To address this issue, PPHI has created a dedicated position of Maternal, Neonatal, and Child Health (MNCH) Coordinator, whose responsibility is to provide on-the-job coaching and training to healthcare providers to enhance their technical skills and attitude towards quality care.

The MNCH coordinators conduct needs assessments of healthcare providers to identify areas where they lack skills and require immediate refresher training.

PPHI invests in both pre-service and in-service education of female healthcare providers in rural areas of Sindh. To address the issue of hiring female providers for MNCH services in these areas, PPHI identifies and selects matriculate girls from those regions and sends them for a two-year Midwifery course in private midwifery institutes such as Ziauddin University Hospital, Isra University Hospital, and Abuzafar Institute of Medical Sciences Koohi Goth Karachi. So far, more than 300 girls have graduated and are serving as midwives in far-flung areas of Sindh. Very recently PPHI Sindh has done MoU with nursing institutions to attach nursing and midwifery candidates at PPHI managed health facilities for practicum/internship.

PPHI has also established 320 BHU Plus, round-the-clock maternal and child health facilities, to provide skilled birth attendants for the management of deliveries. Each facility has a female medical officer in the morning shift and midwives in the evening and night shifts, equipped with necessary supplies, equipment, and medicines. Additionally, most of these facilities have ultrasound and ambulance services available. PPHI conducts several mobilization activities such as community support group meetings, awareness sessions, and radio announcements to increase deliveries at these health facilities.

Midwifery Training

Midwifery training includes the development of a variety of skills, such as performing physical examinations, keeping track of fetal development, evaluating maternal health, helping with childbirth, offering emotional support to mothers and families, and handling complications that could occur during pregnancy, childbirth, or the postpartum period.

Professional ethics and adherence to standards of practice are stressed during midwifery training. The principles of informed consent and collaborative decision-making must be upheld, as well as the rights of women and respect for their choices. Confidentiality must also be maintained.

To stay ahead of the most recent developments in midwifery care and evidence-based practices, midwives are urged to participate in continuing education. This could entail taking part in professional development activities as well as attending workshops, conferences, or online courses.

Performance Evaluation of Midwives

Coming Soon

Tele monitoring

PPHI remotely monitors the work activities and outcomes of its staff to assess their performance. By using tele monitoring tools, supervisors can evaluate whether employees meet the required standards and objectives set by the organization.

PPHI captures and documents relevant data and performance of its staff through tele monitoring systems. This information is used for performance appraisals, identifying training needs, and making informed decisions about career progression within the organization

By remotely monitoring staff members' adherence to specific guidelines, PPHI mitigates risks and maintains quality assurance in its operations.