Date of Award

January 2014

Document Type

Open Access Thesis

Degree Name

Master of Science in Nursing (MSN)


Yale University School of Nursing

First Advisor

Marjorie Funk


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.


This is an Open Access Thesis.

Open Access

This Article is Open Access