Integrating simulations & team-based training into nurse mentoring in Uttar Pradesh

Investigator: Dilys Walker, MD
Sponsor: Bill & Melinda Gates Foundation

Location(s): India


In order to address high levels of maternal and neonatal mortality, the government of Bihar together with the Bill and Melinda Gates Foundation (BMGF) and CARE India launched a program called AMANAT. The AMANAT program is a large quality improvement initiative which aims to improve maternal and neonatal health outcomes in government facilities through interventions at all levels including supply procurement, provider skills, and management.

One component of the AMANAT project is a nurse mentoring program where teams of Nurse Mentors (NM) travel to Primary Health Centers (PHCs) throughout Bihar.  CARE recognized a weakness in mentors’ capacity to teach emergency response so they brought PRONTO International as a simulation and team training expert to develop a new model for using simulation to train nurse and doctor mentors. The mentoring teams mentor in public health care facilities, which are plagued with basic supply and equipment shortages and are consistently understaffed with an extremely high delivery volume.

Under CARE India’s leadership, the AMANAT program with the integration of PRONTO’s approach to simulation and team training has been implemented in 353 facilities through the state. More than 700 government nurses have been trained as mentors and they have mentored over 3,000 staff nurses.

PRONTO’s approach to simulation and team training in the AMANAT program is playing a vital role in improving the quality of obstetric and neonatal care in Bihar.

AMANAT trainings improved intrapartum and newborn care with 37% overall improvement in intrapartum practice scores in normal deliveries, and 26% Improvement in newborn care scores in normal deliveries.