Building sustainable local training capacity for maternal and newborn health within the public health system: A training intervention in Palghar District, India

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Continuing professional development for the health workforce is of paramount importance and can be implemented using locally available, competent trainers. However, guidelines for the selection, development, and mentorship of such trainers are lacking. Training intervention research conducted in Western Maharashtra, India, aimed to address these gaps by focusing on skills for maternal and newborn health (MNH). In this study, selected trainers from a pilot project in the Pune district received advanced training to become core trainers (CTs) for a scale-up project in Palghar district (2019 – 2022). The CTs trained master trainers (MTs) in Palghar (n = 32) with support from the United Kingdom-based technical partners, following a six-step approach: selection of trainers, training of trainers (ToT) (including knowledge and skills assessment), staggered induction as trainers, continuous support, regular quality assessment, and virtual refresher training. The process and outcomes of this six-step approach were evaluated using mixed-methods research. The skills of local trainers were augmented through hands-on training and further supported by long-term mentorship to develop training excellence. The CTs’ competency as mentors improved due to appreciative feedback. Regular assessments conducted by the expert team also contributed to maintaining quality control. Online learning has emerged as an effective method for refresher training. There was considerable improvement in the clinical knowledge and skills of the health providers from Palghar (n = 505), which attests to the quality of the training delivered by the Palghar MTs. This intervention enhanced both clinical competency and confidence. The approach demonstrated the importance of recruiting suitable participants who could consciously shift their teaching style to become more adult-learner-centric facilitators. However, there is a need for a systematic, long-term evaluation of this model, its application to MNH care, and its institutionalization within the public health system.