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REPORT ON THE TRAINING FOR HEALTH CARE PROVIDERS FROM GATSIBO DISTRICT ON COMPRENSIVE PACKAGE
INTEGRATING POST ABORTION CARE, SAFE ABORTION AND FAMILY PLANNING.
Lemigo hotel, October 21 – 25, 2019
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I. Introduction
The training on post abortion care, safe abortion and family planning took place in Kigali, Lemigo hotel from 21 to 25 October 2019. The expected
participants were from the catchment area of Ngarama and Kiziguro D.H. The participation was 5 days 100% (36/36 invited).
The table below shows the qualification of invited participants and their work places.
Invited healthcare providers
Hospital catchment
area
Health facility
Number of
participants
Qualification or position
Kiziguro district
hospital
Gasange H.C 2 1 Nurse and 1 Midwife
Gitoki H.C 1 Nurse or Midwife
Kabarore H.C 2 1 Nurse and 1 Midwife
Kibondo H.C 1 Nurse or Midwife
Kiziguro H.C 2 1 Nurse and 1 Midwife including the one from FP secondary post
Kiziguro D.H 4 1 GBV Officer , 1 Medical Doctor,1 Midwife and 1 Nurse
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Muhura H.C 2 1 Nurse and 1 Midwife including the one from FP secondary post
Rwimitereri H.C 2 1 Nurse and 1 Midwife
Bugarura H.C 1 Nurse or Midwife
Humure H.C 1 Nurse or Midwife
Rugarama H.C 1 Nurse or Midwife
Rwembogo H.C 1 Nurse or Midwife
Ngarama district
hospital
Nyabiheke camp
H.C
1 Nurse or midwife
Gatsibo H.C 1 Nurse or Midwife
Nyagahanga H.C 2 1 Nurse and 1 Midwife
Gituza H.C 1 Nurse or Midwife
Kageyo H.C 2 1 Nurse and 1 Midwife
Ngarama D.H 4 1 GBV Officer , 1 Medical Doctor, 1 Midwife and 1 Nurse
Ngarama H.C 1 Nurse or Midwife
4
Nyagihanga H.C 1 1 Nurse and 1 Midwife
Rangiro H.C 1 1 Nurse and 1 Midwife
Total 36
Among 36 participants, 22 were nurses, 2 medical doctors and 12 midwives with 77.8% (28/36) participation from heath centers. After expressing
their expectations for the training which mostly were related to the acquisition of knowledge and practice of insertion of IUD and implants, practice
of MVA for PAC and safe abortion, the participants fixed some norms to follow during the training period. They selected also the team leader, social
affairs and time keeper.
In his opening remarks, Dr. Ngoga Eugene the RSOG president gave a brief background of Baho Neza project which is implemented by Imbuto
foundation as the leading implementer, in collaboration with RSOG and RBC. The project’s focus is on education (training and mentorship). He
reminded the participants of the objectives of the training and requested them to pay attention on practice, and also to share knowledge and skills
with their colleagues so as to improve women’s health by preventing the complications due to the unsafe abortion. He highlighted that the increasing
rate of family planning users is the most and best prevention of unsafe abortion. He reminded the participants to adopt the good attitudes while
rendering health services, otherwise they will be punished by medical, nurses, or midwives’ councils for any professional misconduct.
II. Activities
The training activities were conducted during 5 days as planned (refer to agenda in annex 1). Participants performed a pretest before the training
and results are shown in the table below:
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Marks Pre-test Post -test
Mean mark 15/ 30 (50 %), 21/30 (70 %),
Lowest mark 8/30 (26.7. %) 15/30 (50 %),
Highest mark 23/30 (76.7 %), 25/30 (83.33 %)
Number of participants scored
below mean mark
16 (44.4%) 0
Number of participants scored
equal and above 60 % marks
13 (36.1%) 33 (91.6%)
Number of participants scored equal
and above 70 % marks
2 (5.5%) 23 (63.8%)
Number of participants scored equal
and above 80 % marks
0 13 (36.1%)
The presentation on PAC, safe abortion and family planning took less time than practice of MVA, insertion and withdraw implants and interval and
post-partum IUD. Participants were very motivated to apply those procedures.
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For the continuity of MVA practice at health center level, the participants were given one Kit of MVA. In addition to the exercises on the use of
MEC wheel participants were given more time to insert and withdraw IUD and Jadelle.
The last day of the training was allocated to the post test, making action plans and formulate recommendations on the side of participants.
Before the closing remarks of RSOG president who insisted on more practice of what they learned and share knowledge with their workmates, the
participants designed and presented to facilitators the action plan as presented in the table below.
D.H action plan after training on PAC, safe abortion and family planning
Detailed activities Expected
outcome
Responsible Resources Period Means of
verification
Presentation on PAC , safe
abortion and F.P
Reinforce staff
knowledge on
PAC, safe
abortion et F.P
Trainees Administration November 2019
Participants attend
list.
Management of abortion
according to the national
protocol
Reduce the
complications
and death due to
abortion
Trainees Hospital October 2019
Register and PAC
report
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Provide health education with
regard to the creation of
awareness of safe abortion
Reduce
abortion rate and
complications
Trainees
Hospital
November 2019
Register of Heath
education
Avail family planning methods
Prevent stock
out
Pharmacist and
trainees
Hospital 30 /10 /2019 Request and store
registers
Provide health education on
post abortion and post-partum
family planning methods
Improve the rate
PPFP use
Trainees Hospital November 2019 PPFP register and report
Admission / orientation of
clients who desire a safe
abortion
Reduce the
number of
unsafe abortion
Trainees including
medical doctor
and GBV officer
hospital November 2019 Safe abortion register
and report
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Health centers’ action plan after training on PAC, safe abortion and Family planning
Detailed activities Expected
outcome
Responsible Resources Period Means of
verification
To help everyone ,in our
institution (nurse/midwife) to be
able to perform Post-abortion
care
Every nurse/
midwife will be
able to manage
post abortion
care
Trained health
care provider
-Knowledge from
Training
MVA kit
Training modules
3 months -Attendance list
- Continuous
training register
Give health education and
sensitize staff members , clients
and community about the
difference between safe
abortion and unsafe abortion
Increased cases
of safe abortion
and reduce cases
of unsafe
abortion
Trained health
care provider
-Knowledge from
Training
-Training modules
- Means of transport
3 months
-Register IEC
- mission order
photos
Promote PPFP and post
abortion family planning with
women’s encouragement about
longue acting and reversible
family planning methods
Increased
number of
women using
PPFP and post
abortion care
Trained health
care provider
--Knowledge from
Training
-Training modules
-Methods of family
planning
Ordonogramme (pictures)
3 months -PPFP register
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Success story
Since March 2019, the Rwandan healthcare providers are trained on Post abortion care (PAC), safe abortion and Family planning ( F.P) by RSOG
in close collaboration with Rwanda Biomedical Center/Ministry of Health (RBC/MoH) with the support of Imbuto foundation through the Baho
Neza project. This training is planned for the 30 districts.
Mr. Tuyishime Valens, a midwife working at Humure health center is among 36 invited healthcare providers from Gatsibo district to participate in
the 10th training. He expressed his feelings.
“When I was receiving an invitation to attend training on post abortion care (PAC), safe abortion and family planning at lemigo hotel, at this time
I was very and very happy because it is the first time I attend the training which is conducted by higher level like RBC (Rwanda Biomedical Center)
and RSOG (Rwanda Society of Obstetricians and Gynecologists).
During this time, I expected the following:
To know safe abortion and unsafe abortion, to classify safe abortion, management and treatment of abortions, rules and regulations to conduct safe
abortions, to practice manual vacuum aspiration (MVA), to know the indications and contraindications of MVA, to practice insertion of intrauterine
device (IUD) and other methods of family planning like: implanon and jadelle, to know the management of side effects of family planning methods.
During the training, my expectations were achieved because there is so much information on abortion I have learnt like: safe and unsafe abortion,
induced abortion, classifications of abortion (complete abortion, incomplete abortion, missed abortion, threatened abortion and septic abortion),
components of post abortion care, post abortion care protocol, treatment of incomplete abortion based on protocol of Rwanda (600 mcg oral single
dose),values clarifications for post abortion care and women’s rights, legal aspects and procedure of termination of pregnancy, I have also learnt
WHO 2018 regimens for medication abortion(mifepristone and misoprostol combination and misoprostol only).
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In family planning I have learnt physiology of menses and physiology of lactation, I have learnt different methods of family planning, their indications
and contraindications and their mechanisms of actions.
After this training:
-I’m going to teach my colleagues or workmates what I have learnt in this training like insertion of IUD as one of best method of family planning
which have effective and efficient.
-I’m going to create awareness on the legal aspects and procedure on the termination of pregnancy to the population living in Humure area
especially women’s and young girls
-I’m going to improve my competence on the management of abortions and family planning methods insertions”.
Said Tuyishime Valens
III. PARTICIPANTS’ RECOMMENDATIONS FROM GATSIBO DISTRICT
After the training on Safe abortion, post-abortion care and Family planning, the healthcare providers from Gatsibo district recommended to:
Participants themselves
Improve quality care through PAC, safe abortion and F.P
Change behavior and mind towards safe abortion
Avail register for safe abortion for data reporting
Provide information, education and communication about PAC, safe abortion and F.P
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RSOG/RBC
Advocate for availability of PAC equipment
Increase the number of healthcare providers trained in PAC, safe abortion and F.P
Facilitate the supervision of health centers and supervise the district hospital
Prepared by: Catherine Musabyimana checked by: Speciosa Kantengwa Approved by: Dr. Ngoga Eugene
Family Planning Officer RSOG Project Manager RSOG President
Kigali, October, 28th 2019
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Annex 1. Training agenda of Gatsibo district
Date Time Topic Facilitator
Day 1,
Monday 21
October 2019
7:30 – 8:00 Registration RSOG
8:00 – 08:30 Introduction of participants
Setting training norms
Expectations from participants
Mr. KANYAMANZA Eugene
8:30 – 9:00 Pre-course assessment Dr. MUGANDA John
09:00 – 09:30 Objectives of the training,
opening
Dr. NGOGA Eugene
09:30 – 10:30 Anatomy and Physiology of reproductive systems Dr. NDAHAYO Philbert
10:30 – 11.00 Coffee break RSOG
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11:00 – 11:45 Overview of PAC Program: Introduction, Definition, Role of
PAC in the Prevention of Maternal Mortality and
Components of PAC
Mr. KANYAMANZA Eugene
11:45 – 13:00 Overview of PAC Protocol….. Dr. MUGANDA John
13:00-14:00 Lunch RSOG
14:00 - 15:00 Overview of PAC Protocol:
Diagnosis and Management, Pain management, Patient
assessment, Methods of Uterine evacuation, Medical
Methods and Surgical Methods.
Dr. SITINI Bertin
Dr. MUGANDA John
15:00 - 17:00 MVA practice on anatomic models Mrs. Kantengwa Immaculée
Dr. MUGANDA John
Dr. SITINI Bertin
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Day 2,
Tuesday 22
October 2019
7:30 – 8:00 Registration RSOG
8:00 – 8:30 Recap Day 1 Mr. KANYAMANZA Eugene
8:30 – 9:30 Criteria of selection of Methods for treatment of incomplete
abortion and Miscarriage, Management of complications,
Values clarifications, Post Procedures follow up and
Infection Prevention.
Dr. HAKIZIMANA Augustin
Dr. MUGANDA John
Mrs. UMUTESI Sharon
9:30-10:30 Legal aspect of Safe abortion Dr. SITINI Bertin
Dr. HAKIZIMANA F Xavier
10:30 – 11:00 Coffee break RSOG
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11:00 - 12:00 Safe Abortion Dr. SITIN Bertin
12:00 – 13:00 Monitoring and Evaluation: Checklist
PAC & safe abortion
Mr. KANYAMANZA Eugene
13:00 - 14:00 lunch RSOG
14:00 - 17:00 MVA Practice on Anatomic Model for
both Safe abortion and Post abortion care
Mrs. Kantengwa Immaculée
Dr. MUGANDA John
Dr. SITINI Bertin
Day 3,
Wednesday
23 October
2019
7:30 – 8:00 Registration RSOG
8:00 – 8:30 Recap Day 2 Mr. KANYAMANZA Eugene
8:30 – 9:30 Physiology of reproductive systems Dr. NDAHAYO Philbert
9:30 – 10:30 Menstrual cycle and lactation Dr. HAKIZIMANA Augustin
10:30 – 11:00 Coffee break RSOG
11:00 – 12:00 Progesterone only methods : pills,
injectable, implants
Dr. MUHIRWA Bonfils
12:00 - 13:00 Combined hormonal methods Dr. MUHIRWA Bonfils
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13:00-14:00 lunch RSOG
14:00 - 15:00 IUD Dr. NGOGA Eugene
15:00 - 1700 Practices on anatomic models/use of
ordinogramme and checklists
Mr. NIYONSENGA Donatien
Mrs. MUSABYIMANA Catherine
Day 4,
Thursday 24
October 2019
7:30 – 8:00 Registration RSOG
8:00 – 8:30 Recap Day 3 Mr. KANYAMANZA Eugene
8:30 – 9:10 Post- partum Family Planning (PPFP) Dr. MUHIRWA Bonfils
9:10 – 10:30 Post -partum Family Planning (PPFP Dr. MUHIRWA Bonfils
10:30 – 11:00 Coffee break RSOG
11:00 – 11:30 Family Planning in PAC Dr. MUGANDA John
11:30 - 12:10 Family Planning in Post-natal Care Dr. MUGANDA John
12:10 - 13:00 Safe Abortion Counseling Dr. HAKIZIMANA F.Xavier
13:00 - 14:00 Lunch RSOG
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14:00 - 17:00 Practices on anatomic models/use of
ordinogramme and checklists
Mr. NIYONSENGA Donatien
Mrs. MUSABYIMANA Catherine
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Day 5,
Friday 25
October 2019
7:30 – 8:00 Registration RSOG
8:00 – 10:00 General recap
Post –Training assessment
Training evaluation
Mr KANYAMANZA Eugene
Dr. SITINI Bertin
10:00-10:30 Coffee Break RSOG
10:30 – 12:30 Plan for next steps and
Recommendations
Mrs. UMUTESI Sharon
Dr. SITINI Bertin
12:30 – 13:30 Lunch RSOG
13:00 - 14:00 Official closing Dr. NGOGA Eugene
14:00 Departure
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Annex 2. Attendance list of participants from Gatsibo district
N0 Participant Names Place Work Qualification Phone email
1 Uwamwezi Peruth Kabarore H.C Nurse 0788868878 [email protected]
2 Mukabwimba Adeline Muhura H.C Midwife 0784730300 [email protected]
3 Maniraguha Odile Gasange H.C Midwife 0786956642 Maniraguha [email protected]
4 Nyirabagabe Donatille Rwimbogo H.C Midwife 0785800433 [email protected]
5 Dukuzuwaturemye Egide Kageyo H.C Nurse 0788378409 [email protected]
6 Tuyishime Valens Humure H.C Midwife 0782567126 [email protected]
7 Mukashimwe Anathalie Ngarama D.H Clinical psychologist / GBV
officer
0788421875 [email protected]
8 Nyinaimanzi Petronille Ngarama H.C Nurse 0788800105 [email protected]
9 Muberampuhwe Lyliose Ngarama D.H Midwife 0788509202 [email protected]
10 Nyirabakiga Jeannette Bugarura H.C Midwife 0781333400 [email protected]
11 Nyampundu Beata Rugarama H.C Midwife 0785755995 [email protected]
12 Nseniyumva Jean Damascene Nyabiheke H.C Midwife 0785037922 [email protected]
13 Hishamunda Alphonse Ngarama H.C Midwife 0785792547 [email protected]
14 Natukunda Patience Nyagahanga H.C Midwife 0786905455 [email protected]
15 Muhire Bienvenue Gakenke H.C Nurse 0783595367 [email protected]
16 Musengimana Janet Gakenke H.C Midwife 0787126390 [email protected]
17 Abayisenga Divine Gitoki H.C Midwife 0782251159 [email protected]
18 Muhoza Clarisse Gatsibo H.C Midwife 0785842389 [email protected]
19 Musindikazi Eugenie Muhura H.C Nurse 0783302149 [email protected]
20 Batamuliza Annonciatha Rwimitereri H.C Nurse 0788646088 [email protected]
21 Uwamariya Dorothee Rwimitereri H.C Midwife 0783391413 [email protected]
22 Uwitonze Marie Aimee Nyagahanga H.C Nurse 0786964754 [email protected]
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23 Mutsinzi Fred Kiziguro H.C Midwife 0787539784 [email protected]
24 Umuhire Immaculee Kiziguro H.C Nurse 0788739747 [email protected]
25 Mukabasinga Pauline Kabarore H.C Midwife 0783201856 [email protected]
26 Kabatesi Beatrice Gasange H.C Nurse 0782328267
27 Munyambibi Leopold Gituza H.C Midwife 0788691787 [email protected]
28 Uwiringiyimana Eunice Nyagihanga H.C Nurse 0783338829 jeanlucnseng02@gmailcom
29 Habineza Robert Kibondo H.C Midwife 0782439241 [email protected]
30 Dr. Steve Fyiroko Ngarama D.H Medical doctor 0780273659 [email protected]
31 Mukarusibira Antoinette Kiziguro D.H Midwife 0783648891 [email protected]
32 Niyomufasha Ellessa Kiziguro D.H GBV officer / Nurse 0788221011 [email protected]
33 Iragena Zena Kiziguro D.H Nurse 0788217829 [email protected]
34 Muhemedi Mbuyi Clement Kiziguro D.H Medical doctor 0782026675 [email protected]
35 Sherif Theoneste Ngarama D.H Nurse 0788573281 [email protected]
36 Muhorakeye Pelagie Ngarama H.C Nurse 0782505037
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Annex 3. Photos
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