Continuous Professional Development (CPD) Unit
A cadre of health professionals who are trained in the latest evidence-based methods and practices is a key component to a well-functioning health system that is adaptable to meet the needs of the population. Given this, Continuous Professional Development (CPD) is an important strategic instrument for improving health and social services. CPD contributes to performance improvement of health providers through standardizing skills according to evidence-based guidelines and practices, improving access to high quality care, enhancing the interactions between providers and facilitating dialogue. As such, since 2003 Juzoor has focused on implementing a number of activities in CPD to upgrade the knowledge base and improve technical skills and performance of providers in the various service settings throughout Palestine and in the region.
At Juzoor, Continuous Professional Development is viewed as both an internal and external process involving many dimensions. Within this philosophy, human resource development is considered a crucial element in not only developing skills, knowledge and attitudes, but also in helping to create an enabling environment whereby organizations can perform effectively, efficiently and in a sustainable manner.
Juzoor strives to bring evidence-based, internationally accredited training programs to the country such as the Advanced Life Support in Obstetrics (ALSO) training from the American Academy of Family Physicians and the Child Health Diploma from the UK’s Royal College of Pediatrics and Child Health.
Juzoor training programs are based on the latest evidence-based information, are grounded in adult learning principles, delivered according to the highest quality, incorporate innovative and dynamic methodologies, and follow a specific lifecycle (see below).
We develop and invest in national teams of trainers in different specialties to deliver training programs according to the latest scientific updates and in accordance with best practices. Juzoor-affiliated instructors come from diverse backgrounds, representing the major stakeholders in the health sector (Ministry, UNRWA, NGOs and private practice), and the health and teaching institutions (universities, medical schools, nursing colleges and hospitals implementing residency training programs) all across the West Bank and Gaza Strip. In addition Juzoor forms strategic alliances on a national basis with bodies such as the Palestinian OB/GYN and Pediatric Societies, the Medical Syndicate and the Palestinian Medical Students’ Union, to ensure the sustainability of CPD activities. Finally, we maintain contact with our instructors, current and former trainees through a database which allows us to organize periodic follow-up activities and distribute updates and new evidence-based information as it becomes available.
In all CPD activities Juzoor targets providers from various sectors including Ministry of Health, UNRWA, NGOs and private practitioners
The CPD Unit organizes two main types of training programs: Emergency and Non-Emergency. The following are descriptions of the continuous professional development activities implemented by Juzoor:
Advanced Life Support in Obstetrics (ALSO): ALSO is an educational program designed to assist healthcare professionals in developing and maintaining the knowledge and procedural skills needed to manage emergencies that can arise in obstetrical care. It is currently implemented in 47 countries around the world and has been translated into numerous languages, including into Arabic by Juzoor. The ALSO training curriculum addresses issues such as: complications of pregnancy, labor and delivery, postpartum hemorrhage, safety in maternity care, and maternal resuscitation. In 2004 Juzoor obtained the exclusive license from the American Academy of Family Physicians (AAFP) to offer this course in the West Bank and Gaza, making Palestine the second country in the Arab world to implement ALSO trainings. Juzoor has ensured that an ALSO certified trainer is present in every major MoH hospital in the West Bank, and the majority of providers trained under ALSO are those from Ministry of Health (midwives, OB/GYNs and residents). This has helped to integrate the ALSO methodology into the working practices of the major public sector OB/GYN wards on a national level. Furthermore, ALSO has become a pre-requisite for those undertaking the Palestinian OB/GYN board exam. The addition of ALSO to reproductive health systems in Palestine has improved access to, standardization of and quality of emergency obstetric care (EOC); enhanced the teamwork approach to obstetric emergencies and the interactions between physicians and midwives; and facilitated dialogue among gynecologists and obstetricians and the pediatricians who participate in the Neonatal Resuscitation training associated with ALSO.
Neonatal Resuscitation Program (NRP): Because neonatal mortality contributes substantially to Palestine’s infant mortality rate, there is a need to improve the quality of neonatal care. To begin addressing this, Juzoor has introduced the American Heart Association’s Neonatal Resuscitation Program (NRP) to Palestine. NRP is a standardized, universally approved training program that is in accordance with the latest evidence-based knowledge and skills. This training has been provided to neonatologists, neonatal nurses, pediatricians and nurses working in neonatal units as well as pediatric and OB/GYN residents and midwives in the West Bank and Gaza. In particular Juzoor has forged alliances with Ibn Sina College, Bethlehem University and Al Quds University to offer this course on a regular basis for nursing and medical students, and NRP has become integrated into the regular teaching program of the nursing school in both Ibn Sina and Bethlehem University (in Bethlehem University it is accredited as one credit hour). The team of trainers in the NRP program include neonatologists, paediatricians and the neontatal nurses from the teaching colleges.
Pediatric Advanced Life Support (PALS): Juzoor began a specialized training course for doctors and nurses in pediatric advanced life support utilizing the methodology of the American Academy of Pediatrics and AHA to address the need for specialized emergency services for children. The course aims to improve children’s access to life-saving care. The target for this training is pediatricians, doctors and nurses working in emergency rooms as well as on pediatric wards. It is integrated into the Palestinian Child Health Diploma course offered in cooperation with the Royal College of Child Health and Paediatrics, as well as offered as a stand-alone course.
PED FACTS: As children make up almost 50% of the Palestinian population Juzoor utilizes a simplified methodology prepared by the American Academy of Pediatrics for teachers and care givers in addressing pediatric emergencies. The training focuses heavily on prevention of accidents and basic care to address emergencies that happen in the community, stabilizing children and preventing further harm before they are able to access medical care.
Hospital Based Emergency Training: Juzoor implemented a hospital based emergency training program across the West Bank targeting doctors and nurses working in hospital emergency rooms. The methodology was prepared and validated by Johns Hopkins University.
Pre- hospital emergency Training: Juzoor also implements pre-hospital emergency training for doctors, nurses and community health workers working in primary health care centers or the community. These efforts have proven important during periods of conflict and crisis, helping providers appropriately respond to an increasing number of emergencies and injuries. These trainings also contribute to building the emergency response capacity of institutions and providers throughout the country, which have long-lasting developmental benefits beyond responding to the emergency needs. The methodology used is adapted from the first aid methodology of the Red Cross/Red Crescent
Basic Life Support (BLS): The Basic Life Support training of the American Heart Association (AHA) has been offered by Juzoor as an integral part of the hospital and pre-hospital based emergency trainings. Juzoor also runs this course separately for health professionals, paramedics and para-professionals. It is a pre-requisite for the ACLS course (see next).
Advanced Cardiac Life Support (ACLS): Following the hospital based emergency trainings Juzoor invested in building capacities in the area of ACLS targeting doctors and nurses working in emergency rooms as well as ICUS and CCUs. The ACLS course is also an AHA methodology and focuses on improving the advanced life saving skills of providers to respond quickly and appropriately to cardiac emergencies.
Non Emergency Programs
Child Health Diploma: Juzoor is cooperating with Al Quds University in Jerusalem and the Royal College of Pediatrics and Child Health in the UK in offering a Palestinian Child Health Diploma for Palestinian doctors and nurses working with children in primary health care settings, as well as for first year pediatric residents. The diploma course focuses on the latest, evidenced-based knowledge and skills in child health issues encompassing a comprehensive approach to children’s health.
Mental Health in Primary Care: In cooperation with the Palestinian Ministry of Health and funded by the French Development Agency (AFD) through the UNDP, Juzoor is implementing a project to train doctors and nurses working in primary health centers (PHCs) in practical skills to address a wide scope of mental health needs of PHC patients, particularly women and children.
Breastfeeding promotion and Protection: Juzoor has developed specialized expertise in this area and in cooperation with the medical and nursing school instructors; Juzoor has developed an updated breastfeeding curriculum with accompanying instructor training manual to standardize breastfeeding education for doctors, nurses and midwives in learning institutions throughout Palestine. The goal of the curriculum is to train students to provide accurate, effective, high-quality breastfeeding counseling to mothers.
Infection Prevention and Control: Juzoor has developed specialized expertise in IPC and has contributed to the development of national protocols in this area for primary health care and hospitals and continues to do so through model building of IPC programs at the hospital level, implementation of trainings, and provision of on-going system support for primary, secondary and tertiary health services.
National Protocols and Guidelines: Juzoor has contributed to the development of national protocols and curricula encompassing antenatal, perinatal, post natal care, maternal and child nutrition, gestational diabetes and hypertensive disorders of pregnancy and non-communicable diseases. Juzoor implements training in these areas as requested and according to need. Under contract by the Flagship Project, in cooperation with the Ministry of Health and local and international consultants, Juzoor coordinated the process to developed up-to-date, evidence-based Standards of Care and accompanying training curricula in Diabetes Mellitus, Bronchial Asthma and Hypertension. Pilot trainings have been implemented and planned for further roll out. The Ministry of Health will validate and implement the Standards of Care on a national level, so that they become the standard operating NCD protocols in the country. This work follows on a successful, similar project to develop protocols for the screening and management of Gestational Diabetes (GDM) and Hypertensive Disorders in Pregnancy (HDP), and advocating their acceptance nationally and training health services providers on how to effectively use these protocols to prevent, screen and manage these illnesses. Currently, Juzoor with local and international expertise, is building on these successes in addressing NCDs on a wider level among health providers and on the community level through the development of guidelines, protocol, training curricula and models of community based prevention and care.