Carolyn P Bell, FNP/CNM/MPH, Maternal and Child Health, University of California, Berkeley, 14491 Southern Ave, Guerneville, CA 95446, 707-887-1314, cbell@uclink.berkeley.edu and Suellen Miller, CNM, MHA, PhD, School of Public Health, University of California, Berkeley, 308 Warren Hall, UC-Berkeley, Berkeley, CA 94720.

Purpose: A project aimed at improving birth outcomes in rural Tibet, where the rates of maternal and infant mortality are among the world's highest, is being sponsored by an international NGO, One H.E.A.R.T. (Health, Education, and Research in Tibet).

Methods: Rural health workers are trained in midwifery skills in a three-month-long course which combines didactic and clinical training in both western and traditional Tibetan medicine. Participants gained experience and skill in prenatal care, deliveries, newborn care and problem recognition. Further training in life-saving skills and best practices was attended by program graduates and clinic administrators. Pre-post tests were given to evaluate effectiveness of the training on knowledge scores. Focus groups also explored health education and outreach strategies. Improved data collection and reporting systems were implemented to monitor the effect of these interventions.

Results: Fourteen participants completed this year's midwife training course. Rural health worker's post-test scores improved from 38%-88% on biomedical knowledge and 44% to 90% on Tibetan medical curricula. Twenty eight participants in the life-saving skills course showed a mean improvement from 57 to 90%. The findings of the focus groups were used to develop an educational video for families in the rural villages on the danger signs of pregnancy and childbirth.

Recommendations: Participants found the trainings helpful, and more trainings are planned for the future in hopes of improving birth outcomes. The video was reproduced and distributed for use rural villages. Monitoring and evaluation of county level indicators will now be possible.

Learning Objectives: