OGWH is heading into the second year of the MSH Health Impact on the USAID Madagascar Accessible Continuum of care and Essential Services Sustained (ACCESS) program with an extensive training plan for clinical capacity building and AIM implementation.

ACOG’s role in the USAID madagascar ACCESS program is to help build capacity in training of health professionals specifically in maternal care, safe surgery and management of emergencies.

In November 2019, Scott Eder, MD FACOG, FACS, went to Madagascar to deliver three 5 day training in Toliara and Antananarivo.

The goal of these workshops was to enhance the capacity of ACCESS staff in the clinical capacity development and technical assistance needed to implement the training strategy.

ACOG’s role in this short-term technical assistance program was to train the trainers on the Alliance for Innovation for Maternal health (AIM) bundles relating to post-partum hemorrhage and preeclampsia. Additionally, educational presentations on family planning including LARC and quality improvement were delivered. The programs were held in collaboration with representatives from the American Academy of Pediatrics (Dr. Carlos Ramos) and American College of Nurse Midwives (Rebecca Ullman, CNM) who presented on maternal-child health.

The 35 participants in Toliara and 80 participants in Antananarivo were from 13 regions at the regional and district levels. The trainees including health workers, nurses, midwives, physician generalists and to ob-gyns.

The materials were prepared in collaboration with Drs. Eder and Ramos and Shawn mattson, MD, FACOG and written and delivered in French.


The Year 2 Workplan activities include a scale-up of the AIM bundles for post-partum hemorrhage and hypertension, making AIM a centerpiece for the ACOG deliverables. Challenges include creating an optimal, scalable training that can be implemented into a culture of learning.

During the implementation phase, training and orientations will be conducted in parallel within the different districts depending on the availability in number and time of the trainers.

ACOG will be providing sessions on the following topics: Orientation to the Professional Association Strengthening Manual; How to set-up and AIM steering committee; Best practices for postpartum IUD insertion; Overcoming provider bias and adolescent family planning; Post-partum hemorrhage case conferencing; and Pre-eclampsia and eclampsia case conferencing.

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