Strengthening healthcare providers’ capacity for intra-uterine device and contraceptive implant services in humanitarian and fragile settings: a case study from Nepal using the clinical outreach refresher training model (S-CORT)

Abstract Background – Access to modern family planning methods, including long-acting and reversible contraceptives (LARCs), to prevent unplanned pregnancy is critical to avert maternal deaths in humanitarian and fragile settings, where clinicians often have limited LARC competencies. This paper explores the perspectives and recommendations of providers and trainers involved in piloting the Clinical Outreach Refresher Training for Sexual and Reproductive Health module (S-CORT) on LARCs in Nepal.Methods – Qualitative data from end-of-training evaluations, which were self-filled by 15 trainees, a focus group discussion involving 11 of them, and written feedback from five co-trainers were transcribed, coded, and thematically analyzed. Results were intersected with those from pilots held in Bangladesh and the Democratic Republic of Congo.Results – Results suggest that the module could increase participants’ counseling and clinical skills, help anchor readiness for family planning and LARC provision before humanitarian emergencies, and reinforce informed consent, service privacy and confidentiality, and access for underserved populations, including adolescents. Recommendations for improvement included the advanced provision of the learning resources for self-study to promote blended learning and avail more clinical practice time.Conclusions – When the lack of skilled human resources is a barrier to LARC services in humanitarian and fragile settings, the S-CORT strategy could offer a rapid hands-on refresher training opportunity for clinicians requiring knowledge and skills update. Such a capacity-development approach could be valuable not only for emergency response but also in contexts prioritizing disaster preparedness planning.