LAUSR

At a low-resource small district hospital in rural Sierra Leone, there had been difficulties incorporating post-partum family planning into maternity care due to training and material challenges. Hence, there were learning needs to increase staff knowledge, communication skills and technical expertise. Traditional methods of continuing postgraduate education (CPD) involving nationally organised, standardised courses with external facilitators and minimal follow-up were ineffective because they were top down and not ongoing. A local context of economic instability, low staff morale, geographical separation from training activity centred in the capital city, equipment deficits and the absence of a culture of locally authentic CPD activity were contributing factors. Tailored interventions are interventions following investigations into the determinants of clinical practice that can help or hinder learning and change. The determinants can be delineated by the terms enablers, barriers, obstacles and facilitators.