2.1.1     Overall objective:

Objectives of this intervention include the development of Midwifery Master Trainers from the currently practicing Midwifery Supervisors. Through a two-pronged approach, 350 Midwife Supervisors will be strengthened to the level of Master Trainer:  Participants will obtain the required knowledge and skills from tailor-made video lessons in three modules covering clinical, professional and technical topics critical for this expanded role; weekly video lessons will be supplemented by individual  (1:1) coaching mentoring  support  to  enable Supervisors  to  embed new  knowledge and skills into their supervision practices, strengthen their leadership abilities, and continuously develop them professionally as Master Trainers of practicing Midwives. The provision of specially prepared content ensures  that  Supervisor  Midwives  have  access  to  valuable  resources  at  their  convenience and coaching assures the learning has been effective and its applicability to their training responsibilities.

2.1.2     Specific Objectives:

Specific objectives of strengthening Supervising Midwives through video lessons and coaching/mentoring include:

1.   Needs assessment: To conduct the needs assessment, which involves identifying key stakeholders, and partners, and to identify 350 existing Supervisor Midwives working with public/private  health   institutions   and  understanding  their  specific  needs  through  Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs). This information is used to develop tailored training and development content, including blended approaches such as video lessons and online mentoring/coaching. By involving stakeholders and Supervisor Midwives in the assessment, their perspectives and inputs are valued, ensuring that subsequent initiatives are relevant and effective in addressing their specific needs and closing knowledge and skill gaps.

2.     Develop tailored video documentaries: To develop 20 customized video lessons of 30-45 minutes each in Dari, Pashto, and Uzbek languages covering clinical skills, professional skills, and technical skills. These documentaries will be designed to provide relevant and engaging content that enhances the knowledge and skills of the coaches/mentors.

3.    Piloting  and  finalizing  of video  lessons: The pilot phase  of  10  working  days  of  learning through video lessons involves providing developers, trainers/facilitators, and Supervisor Midwives with the training content and assessing its effectiveness through pre- and post- tests (administered before and after each video lesson). This process allows for refinement and adjustments, if necessary, based on the evaluation results. By conducting these tests, the

effectiveness of the video lessons in enhancing knowledge and skills can be measured, ensuring that the training meets the desired objectives and leads to improved performance. The feedback gathered during this pilot phase is crucial for refining and adjustment of the content and ensuring its effectiveness in preparing supervisor midwives for their roles.

4.   Conduct blended training: AABRAR will provide a comprehensive six-month training program for Supervising Midwives and incorporate a dynamic blend of video lessons and personalized

1:1 coaching and mentoring sessions. This blended approach ensures a well-rounded learning experience, support for applicability of the learning, combining the convenience of online resources  with  the  invaluable  guidance of  coaching  and  mentoring  support. The  training program will:

a.      Enhancing  Knowledge  and  Skills:  Provide  Supervisor  Midwives  with  access  to educational video lessons that cover topics such as best practices, evidence-based guidelines, and the latest advancements in midwifery care. The aim is to expand the knowledge and enhance the skills of supervising Midwives so that they can further train and develop field-based Midwives, enabling them to provide quality care.

b. Strengthen Leadership Abilities: To develop the leadership abilities of the coaches/mentors. This objective focuses on enabling Coaches to provide 1:1 mentoring that empowers the Supervisor Midwives to become effective leaders and trainers.  By enhancing  the  leadership  and  training  skills  of  the  Supervisors,  the Coaches can inspire and motivate the Supervising  Midwives  to  improve their performance and outcomes.

c.    Assure  Effective  Learning:  To  ensure  that  the  learning  provided  through  video lessons  and  mentoring  is  effective.  This  involves  evaluating  the  outcomes  of  the video lessons and mentoring interventions of the Coaches/Mentors. The aim is to measure the effectiveness of each lesson as well as the overall program.

d.    Standardizing and Improving Supervision: Develop mentoring programs that focus on improving the supervisory skills and training capacities of Supervisor Midwives. This includes providing guidance on effective supervision techniques, strengthening skills for training techniques, ensuring compliance with national guidelines and standards, and  promoting  consistent  and  high-quality  care  across  healthcare facilities.

e.     Enhancing the Quality of Care: Through video lessons and mentoring, emphasize evidence-based practices and quality improvement measures. Supervisor Midwives will learn how to promote the implementation of these practices among the Midwives under their supervision, train field-based Midwives to conduct clinical and non-clinical audits, and enhance the overall quality of midwifery care provided to women and newborns.

f.     Promoting Continuous Professional Development: Ensure the availability of easily accessible and on-demand content, such as video lessons and online resources, that Supervisor Midwives can access anytime. This encourages their continuous learning, and participation in conferences, webinars, and online courses to stay updated on the latest research and trends in midwifery and core skills required for Master Trainers of field-based Midwives.

g.   Fostering Collaboration and Networking: Create platforms for Supervisor Midwives to connect and collaborate through virtual networks, online forums, and video conferences. This facilitates  the exchange of experiences, knowledge sharing, and the establishment of a supportive professional network to improve the supervision of midwifery and overall midwifery services.

2.1.3     Target Groups and Final Beneficiaries

The target group of this capacity-building project would be Supervisor Midwives who are currently

managing and leading field-based Midwives. The project aims to enhance the skills, knowledge, and competencies of Supervisor Midwives to improve the quality of training they deliver to field-based Midwives and enhance the care provided to mothers, newborns, and families. By equipping Supervisor Midwives with additional skills and knowledge, they can take on roles as Master Trainers and further support and guide the field-based Midwives under their supervision, ensuring high- quality care and professional development.

The proposed selection criteria for Supervising Midwives for the project include a combination of qualifications, experience, and personal attributes:

a)     Qualifications:  Demonstrated  certification  as  a  Midwife,  Diploma  of  Midwife,  Registered Midwife indicating successful completion of relevant education and training programs. Additional certifications or specialized training may also be considered.

b)   Experience: Minimum 5 years of proven experience as a Supervising Midwife, preferably with a track record of clinical management responsibilities. A solid understanding of clinical Best Practices, risk assessment procedures, and treatment protocols are essential.

c)     Leadership Skills: Strong leadership qualities, including the ability to effectively guide and

inspire a team of Midwives as well as individual field-based Midwives. Candidates should demonstrate excellent communication, organizational, and problem-solving skills.

d)    Interpersonal Skills: Excellent interpersonal and teamwork skills to  effectively collaborate

with other healthcare professionals, patients, and their families. Compassion, empathy, and cultural sensitivity are essential for building trusting relationships.

2.1.4     Specific problems to be addressed by this action:

Supervising Midwives plays a crucial role in overseeing and guiding  field-based Midwives in their practice, ensuring the provision of quality maternal and newborn care. Supervising Midwives in Afghanistan face several specific problems that can be addressed through the mix capacity-building

training (video  lessons  and  coaching/mentoring) in Supervising Midwife Clinical  Skills, Supervising Midwife Professional Skills, and Supervising Midwife Technical Skills. Here are some of the key challenges they encounter:

1.   Limited clinical skills: Supervising Midwives in Afghanistan may lack up-to-date knowledge and

proficiency in clinical skills, including risk assessment, antenatal care, intrapartum care, postnatal care, and essential newborn care. This could hamper their ability to provide quality care and handle complicated cases effectively, or, inhibit their confidence and capacity to train

the field-based Midwives under their supervision.

2.    Insufficient technical skills: The use of modern medical equipment and technology is limited

in many healthcare facilities in Afghanistan. Supervising Midwives may lack proficiency in using and maintaining essential equipment, such as fetal monitors, ultrasound machines, and neonatal  resuscitation  devices.  Enhancing their technical  skills will enable them  to  utilize available resources effectively, and, provide technical training and capacity building for the field-based Midwives under their supervision.

3.   Limited knowledge of evidence-based practices: Keeping up with the latest evidence-based

practices and guidelines can be challenging for Supervising Midwives. They may struggle to incorporate evidence-based care into their daily practice, leading to outdated or suboptimal care. Training they provide to the field-based Midwives under their supervision should focus on updating knowledge and promoting the use of evidence-based guidelines.

4.    Keeping up with changing guidelines and protocols: Healthcare guidelines and protocols for maternal and newborn care are constantly evolving based on emerging evidence and best practices. Supervising Midwives need to stay updated with these changes to ensure that