24/07/2026
Bridging the Gap Between Training and Practice: Institutionalizing Competency-Based Assessment for Maternal and Child Health Services in Khyber Pakhtunkhwa
High-quality maternal and child healthcare depends not only on well-designed training programs but also on the ability of healthcare providers to confidently apply their knowledge in real clinical settings. While Maternal and Child Health (MCH) trainings have long been conducted across the province by the Health Department and its development partners, these trainings often focused predominantly on knowledge transfer. A critical gap remained between classroom learning and the practical competencies required to deliver quality services at health facilities.
Recognizing this need, the National Health Support Program (NHSP), funded by the World Bank and implemented in close collaboration with the Health Department Khyber Pakhtunkhwa, introduced an innovative competency-based approach that transforms training from a knowledge-sharing exercise into a measurable process of skills development and performance improvement.
The journey began with the development of standardized competency assessment tools for five priority Maternal and Child Health (MCH) modules:
• Pregnancy, Childbirth, Postnatal Care and Newborn Care (PCPNC)
• Integrated Management of Newborn and Childhood Illness (IMNCI)
• Kangaroo Mother Care (KMC)
• Labour Care Guide (LCG)
• Family Planning
These competency assessment tools were developed with the support of technical experts and subject specialists, ensuring alignment with national guidelines and evidence-based clinical practices. Following a comprehensive technical review, the Health Department officially endorsed these tools, marking an important milestone in institutionalizing competency-based assessment within the provincial health system.
With the endorsed tools in place, NHSP successfully organized competency assessment trainings across 10 priority districts. Each district nominated 8 participants from relevant healthcare cadres, while five representatives as provincial resource persons, bringing together 85 healthcare professionals for intensive capacity building.
Unlike conventional trainings, these sessions placed strong emphasis on hands-on learning and practical skill development. Participants practiced essential clinical procedures through simulation exercises using mannequins in the training venue and also attended supervised clinical sessions in attached hospitals, where they observed and performed relevant procedures under the guidance of experienced facilitators. This combination of simulation-based learning and real clinical exposure ensured that participants developed the confidence and competencies required for quality service delivery.
In parallel, participants were trained on the use of standardized competency assessment tools to objectively evaluate clinical skills across all five MCH modules. Their own competencies were assessed throughout the training using structured scoring criteria, and based on their performance, high-achieving participants were recommended as Master Trainers to lead future cascade trainings at the district level.
The impact of this initiative extends far beyond the training venue.
These Master Trainers will now conduct district-level trainings for Medical Officers, Women Medical Officers, Nurses, Lady Health Visitors, Medical Technicians, and other frontline healthcare providers serving in Basic Health Units (BHUs) and Rural Health Centres (RHCs). However, the process does not end with training. Approximately one month after the cascade trainings, participants will be assessed again at their own health facilities while performing their routine clinical responsibilities. This workplace-based competency assessment will ensure that newly acquired knowledge and skills are translated into improved clinical practice and better-quality healthcare services.
This initiative represents a significant shift from traditional training models towards a sustainable system of competency-based learning, supportive supervision, and continuous quality improvement. Rather than measuring success by the number of trainings conducted, NHSP has introduced a system that measures whether healthcare providers can effectively apply their skills where they matter most—at the point of care.
Ultimately, the greatest beneficiaries of this initiative are the mothers, newborns, children, and families who rely on quality healthcare services at their nearest health facilities. Every competent healthcare provider contributes to safer pregnancies, better childbirth outcomes, healthier newborns, improved child survival, and a stronger primary healthcare system.
By institutionalizing competency-based assessment and strengthening practical clinical skills, the National Health Support Program is not only building the capacity of healthcare providers but also fostering a culture of quality, accountability, and continuous improvement within the health system of Khyber Pakhtunkhwa.
From knowledge to competence. From training to transformation. From stronger skills to healthier communities.
