Methods
Study setting and area
The evaluation was conducted on the training given in two Hospitals in SNNPR selected by the program facilitators. These are Mizan-Tepi University Teaching Hospital and Sawula General Hospital which are located at 585 km and 514 km away from Addis Ababa, respectively.
Design
A formative evaluation was conducted by applying the Kirkpatrick training evaluation model. The model is known well world-wide and comprises four levels. The four levels are reaction (level 1), learning (level 2), behavior (level 3), and result (level 4) [13]. Further detail about the Kirkpatrick model is presented as Additional file 1.
Trainers and trainees
The Village Health Partnership provided training of trainers for six senior lecturers on HBB and ECEB training. The six trainers (3 pediatric Nursing specialists, 2 General Practitioners, and 1 Clinical Midwife) provided the training for five rounds starting from 2018–2019.
A total of 98 health care providers encompassing nurses, midwives, anesthetists, and health officers who came from Gamo, Goffa, and Bech-Sheko Zones of SNNPR were trained. These trainees were those who were involved in newborn care, and selected by their respective health facilities. The training was given for four days by dividing the trainees into five sub-groups with a ratio of one trainer to five trainees as per the protocol.
HBB and ECEB training
HBB and ECEB training is an evidence based program developed by AAP and its partners to train health care providers to equip them with knowledge and proper skill of neonatal resuscitation in resource limited countries [6, 7]. The HBB training consists of four main lessons: preparation for birth, routine care, the Golden minute, and ventilation with normal or slow heart rate. The ECEB training addresses continuing skin to skin care, initiation of breast feeding, provision of eye and cord care, provision of vitamin K, examination of the baby, measurement of temperature, weighing, and classifying the baby [7]. The training contains action plan, provider guide, facilitator guide, flipcharts, and materials for demonstration.
Evaluation of knowledge
Following necessary orientations, a pre-test with 18 standardized multiple choice questions was given to assess the knowledge of trainees about the HBB course contents. Immediately after the completion of HBB training, the trainees were re-evaluated using similar 18 multiple choice questions used in the HBB pre-test. Similarly, before starting the ECEB training, a pre-test with 25 standardized multiple choice questions was given to assess the knowledge of trainees about ECEB course contents. After completion of the ECEB training, the trainees were re-evaluated using similar 25 multiple choice questions used in ECEB pre-test.
Evaluation of satisfaction
The trainees’ satisfaction was evaluated using seven standardized questions with five likert scales arranged from strongly disagree to strongly agree along with two open ended questions. The trainees’ were asked their satisfaction after completing the HBB and ECEB training.
Operational definitions
Knowledge: The immediate knowledge acquired as a result of the training measured by comparing the mean score of pre- and post-test results.
Satisfaction: Trainees who scored mean and above the mean were considered as satisfied but otherwise they were considered as unsatisfied.
Data collection
Data were obtained from the reporting documents of HBB and ECEB training deposited at Mizan-Tepi University Educational Development Center (EDC). EDC is responsible for coordinating the HBB and ECEB training. The trainees’ profile, their knowledge and satisfaction scores are available at the EDC. Two trained BSc nurses collected data using the data extraction formats presented as Additional files 2, 3, 4, 5.
Statistical analysis
Data were entered into Epi Info 7 and imported to SPSS version 21.0 for analysis. Descriptive statistics (frequencies and percentages) were computed to describe trainees’ socio-demographic characteristics and level of satisfaction. A Paired Samples T-test was used for comparing the pre-test and post-test mean knowledge score difference of the trainees. The statistical significance was determined at p-value < 0.05.