The Ethiopian National MDSR Training Package was developed by the Federal Ministry of Health MDSR Task Force, with technical support from Evidence for Action and WHO.
In Ethiopia, the MDSR system was officially launched in May 2013, and a national level Train-the-Trainers workshop was conducted at that time by a multi-sectoral team drawn from the Task Force membership, the Ethiopian Society of Obstetricians and Gynaecologists (ESOG), and the E4A technical assistance team. Following the national training workshop, a “training cascade” was introduced. Each Regional Health Bureau has been responsible for rolling-out the MDSR training to relevant participants in their regions.
Initially, Maternal and Child Health staff were trained using the MDSR Technical Guideline. In 2014, the MDSR system was integrated with the Public Health Emergency Management (PHEM) directorate in the Ethiopian Public Health Institute (EPHI). Since then, surveillance officers have been trained using the PHEM Implementation Manual for MDSR.
The training materials, including the Trainers’ Manual, are designed to support delivery of a comprehensive introduction to the Ethiopian MDSR system, including familiarisation with the data collection tools, and roles and responsibilities at each level of the health system.
The training package
The training package is available to download below. It consists of the following materials:
- The Technical Guideline (2014 revision) This is available here for reference. It is no longer used and has been superseded by the PHEM Implementation Manual for MDSR.
- PHEM Implementation Manual for MDSR
- A Trainers’ Manual (with all powerpoint slides, group activities and solutions, and trainers’ tips), including
- Sample training agenda
- Pre- and post-tests
- 11 training modules including the ten power point presentations below
- Definitions and MDSR structure
- Legal considerations
- Why did Mrs X die?
- Identification and notification
- Committee TOR setting
- Facility reviews
- Understanding maternal deaths determinants
- Community data capture
- Moving to action
- Implementing responses
- Appendix A: MDSR global movement
- Appendix B: evidence of effectiveness
- A video in mp4 format (also freely available from the internet)
- Participant workbook
- Answer book
- Handouts related to the module on community data collection
The training package has been designed to be interactive. The emphasis throughout the training should be on the use of MDSR as a basis for action. The importance of multi-professional team collaboration is also emphasised throughout the training, as this has been shown to benefit the MDSR system by strengthening communication between disciplinary groups (clinicians, midwives, data managers, community representatives, etc). Where possible, training at each level should be delivered by a multi-disciplinary training team.
Overall Goal of the Training Package
To deliver a practical introduction to the Ethiopian MDSR to support establishment of a functional, effective and action-oriented MDSR system across Ethiopia.
- Introduce MDSR concepts and rationale, with presentation of international evidence for its effectiveness and best practice
- Provide a detailed overview of the Ethiopia MDSR model and vision for how it will operate at each level of the national health system
- Ensure staff are equipped with the requisite knowledge and competence-based skills for each component of the MDSR process
- Provide an opportunity for participants to become familiar with the use of the National Guidelines and tools for data collection and reporting.
Target Audience and Objectives
Twelve training modules have been developed, although not all of them are relevant to all participants. The sample training workshop agenda provided in this manual makes suggestions for which modules can be adapted, shortened or removed for specific groups.
Four different levels are envisioned for delivering the training, each with slightly different primary objectives, as follows:
- National and Regional leads – political commitment, orientation of the system
- Referral/District Hospitals – facility based data collection
- Zones and Woreda – managing data flow, identifying actions and reporting upwards
- Health centres – collecting and reporting data from both community and facilities
By the end of each training workshop, participants should:
- Understand how MDSR can reduce maternal mortality
- Know the structure of the Ethiopian MDSR, including roles and responsibilities
- Recognise and know how to use the national Tools
- Demonstrate ability to recommend appropriate actions
- Appreciate the importance of MDSR processes, particularly the need for smooth bi-directional flow of information between different levels of the system
- Understand the role of monitoring actions to ensure the “response cycle” is completed
Trainings should be completed prior to the initiation of MDSR in each region, and should ensure dissemination of PHEM Integration Manual and Tools to all relevant institutions and individuals who will be involved in implementing the MDSR.