Cherrie Evans and Peter Johnson provide important feedback on the implementation of recommended changes to the Helping Mothers Survive Bleeding After Birth training program in their letter to the editor.

The changes that we have suggested (full day training session instead of half day training session, translation of the teaching materials into the local language, and validation of facilitators by means of knowledge and skills testing) [1] have been implemented in the latest version of the Helping Mothers Survive Bleeding After Birth training program.

To ensure good quality training it is important that training programs continue being monitored and evaluated. This will provide evidence-based feedback on the perception of the training by its trainees and facilitators and on the effect that it has on their knowledge and skills. This is especially important for a training program such as Helping Mothers Survive Bleeding After Birth that is going to be rolled out worldwide. The settings in which the training program will take place will differ from setting to setting. Therefore structured feedback will provide important information to facilitate adjustment of the training program (when needed), thereby ensuring maximum training effect and enhancing implementation.

We are looking forward to seeing the results of the study of Cherrie Evans and Peter Johnson in Uganda, which will provide feedback on the training program as it is currently practiced.


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    Nelissen E, Ersdal H, Østergaard D, Mduma E, Broerse J, Evjen-Olsen B, et al. Helping mothers survive bleeding after birth: an evaluation of simulation-based training in a low-resource setting. Acta Obstet Gynecol Scand. 2014;93:28795.