Objective: To evaluate a cohort of graduates from a grassroots skilled birth attendant training program in Haiti to determine if they meet global standards of competency established by the International Confederation of Midwives.
Design and setting: A testing instrument that included both a 50-question, multiple choice knowledge test and two emergency skills tests (postpartum hemorrhage and neonatal resuscitation) was adopted from the USAID Quality Assurance Project. A convenience sample of 30 skilled birth attendants completed the knowledge test and, of this cohort, a random sample of 18 completed the skills test. Data collection took place in Hinche, Haiti in July, 2013.
Findings: On average, participants were correct for 59% of the knowledge questions, 34% of the skills steps for postpartum hemorrhage, and 39% of the skills steps for neonatal resuscitation.
Conclusions: Emphasizing emergency simulation training and opportunities to refresh emergency skills periodically is recommended to ensure competency in a cohort of skilled birth attendants. This research is discussed in the context of the Haitian health care system fraught by extreme poverty, lack of basic infrastructure, and a critical shortage of healthcare workers.
","abstract_html":"<p>Objective: To evaluate a cohort of graduates from a grassroots skilled birth attendant training program in Haiti to determine if they meet global standards of competency established by the International Confederation of Midwives. </p> <p>Design and setting: A testing instrument that included both a 50-question, multiple choice knowledge test and two emergency skills tests (postpartum hemorrhage and neonatal resuscitation) was adopted from the USAID Quality Assurance Project. A convenience sample of 30 skilled birth attendants completed the knowledge test and, of this cohort, a random sample of 18 completed the skills test. Data collection took place in Hinche, Haiti in July, 2013. </p> <p>Findings: On average, participants were correct for 59% of the knowledge questions, 34% of the skills steps for postpartum hemorrhage, and 39% of the skills steps for neonatal resuscitation. </p> <p>Conclusions: Emphasizing emergency simulation training and opportunities to refresh emergency skills periodically is recommended to ensure competency in a cohort of skilled birth attendants. This research is discussed in the context of the Haitian health care system fraught by extreme poverty, lack of basic infrastructure, and a critical shortage of healthcare workers.</p>","abstract_has_math":false,"creators":["Zickler, Nicole"],"institution":null,"degree_name":"Master of Science in Nursing (MSN)","degree_level":"Open Access Thesis","degree_discipline":"Yale University School of Nursing","degree_department":null,"school":null,"contributors":["Marjorie Funk"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2014,"date_issued":"2014-01-01T08:00:00Z","date_published":"2014-01-01T08:00:00Z","updated_at":"2026-07-24T06:16:00Z","subjects":["Assessment, Haiti, Maternal mortality, Millennium Development Goals, Skilled birth attendance, Skilled birth attendants"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://elischolar.library.yale.edu/ysndt/1019","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Marjorie Funk"]},{"key":"dc:creator","label":"Author","values":["Zickler, Nicole"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Yale University School of Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Open Access Thesis"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Master of Science in Nursing (MSN)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Assessment, Haiti, Maternal mortality, Millennium Development Goals, Skilled birth attendance, Skilled birth attendants"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://elischolar.library.yale.edu/ysndt/1019"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Objective: To evaluate a cohort of graduates from a grassroots skilled birth attendant training program in Haiti to determine if they meet global standards of competency established by the International Confederation of Midwives.
Design and setting: A testing instrument that included both a 50-question, multiple choice knowledge test and two emergency skills tests (postpartum hemorrhage and neonatal resuscitation) was adopted from the USAID Quality Assurance Project. A convenience sample of 30 skilled birth attendants completed the knowledge test and, of this cohort, a random sample of 18 completed the skills test. Data collection took place in Hinche, Haiti in July, 2013.
Findings: On average, participants were correct for 59% of the knowledge questions, 34% of the skills steps for postpartum hemorrhage, and 39% of the skills steps for neonatal resuscitation.
Conclusions: Emphasizing emergency simulation training and opportunities to refresh emergency skills periodically is recommended to ensure competency in a cohort of skilled birth attendants. This research is discussed in the context of the Haitian health care system fraught by extreme poverty, lack of basic infrastructure, and a critical shortage of healthcare workers.
"]},{"key":"dc:title","label":"Title","values":["Skilled Birth Attendant Assessment In Haiti: A Pilot Project"]}]}],"canonical_facts":{"dc:contributor":["Marjorie Funk"],"dc:creator":["Zickler, Nicole"],"dc:description.abstract":["Objective: To evaluate a cohort of graduates from a grassroots skilled birth attendant training program in Haiti to determine if they meet global standards of competency established by the International Confederation of Midwives.
Design and setting: A testing instrument that included both a 50-question, multiple choice knowledge test and two emergency skills tests (postpartum hemorrhage and neonatal resuscitation) was adopted from the USAID Quality Assurance Project. A convenience sample of 30 skilled birth attendants completed the knowledge test and, of this cohort, a random sample of 18 completed the skills test. Data collection took place in Hinche, Haiti in July, 2013.
Findings: On average, participants were correct for 59% of the knowledge questions, 34% of the skills steps for postpartum hemorrhage, and 39% of the skills steps for neonatal resuscitation.
Conclusions: Emphasizing emergency simulation training and opportunities to refresh emergency skills periodically is recommended to ensure competency in a cohort of skilled birth attendants. This research is discussed in the context of the Haitian health care system fraught by extreme poverty, lack of basic infrastructure, and a critical shortage of healthcare workers.
"],"dc:identifier":["https://elischolar.library.yale.edu/ysndt/1019"],"dc:subject":["Assessment, Haiti, Maternal mortality, Millennium Development Goals, Skilled birth attendance, Skilled birth attendants"],"dc:title":["Skilled Birth Attendant Assessment In Haiti: A Pilot Project"],"thesis:degree_discipline":["Yale University School of Nursing"],"thesis:degree_level":["Open Access Thesis"],"thesis:degree_name":["Master of Science in Nursing (MSN)"]},"updated_at":"2026-07-24T06:16:00Z"}