This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS DJIBOUTI 000300 
 
SIPDIS 
 
STATE FOR AF AND AF/E 
STATE PASS USAID 
PARIS /LONDON FOR AFRICA WATCHER 
 
E.O. 12958: N/A 
TAGS: PREL PGOV SOCI EAID DJ
SUBJECT: TRAINING TRAINERS IN PRIMARY HEALTH CARE IN DJIBOUTI 
 
¶1. (U)  A USAID-funded week-long training session for health 
practitioners in Djibouti began March 19, 2005 with an official event a 
the National Health Training Center in the capital.  Focus of the 
training was to impart primary health care teaching skills to selected 
candidates who would return to their respective districts and begin 
training various cadres of health workers who manage rural health 
clinics. These health clinic workers included nurses, traditional birth 
attendants and community health extension agents. 
 
¶2. (U)  The candidates themselves number 22, and came from each of the 
five districts in the country. Candidates from each district were 
selected by the district medical doctor, and spent six days in this 
intensive "training of trainers" course. The district medical 
doctors were also included among the candidates for training. 
 
¶3. (U) During the opening ceremony,  Director of the Training Center, 
Hassan Kamil thanked USAID Representative and the implementing partners 
for their organization of the training course.  USAID Chief of Party fo 
the Health Sector Reform Project, Dr. Stanislas Nebie, cited the 
collaborative effort that was put forth to make this launching of 
the second component of USAID's three-component program successful. He 
stressed that one of the important outcomes of this training will be to 
improve supervision skills of these trainees, as this will ensure 
continued high quality of health service delivery. Ambassador Ragsdale 
noted overall U.S. health assistance to Djibouti as an effort to 
improve the lives, and in particular the health of women and children. 
She added that the training course was another important step in this 
continuing and growing collaboration, with the aim of enhancing the 
capacity of those responsible for delivery of health care 
services in rural areas.  Secretary General of the Ministry of Health, 
Dr. Saleh Banoita, thanked USAID and the implementation team for 
organizing the course, which he said would assist the Ministry of Healt 
better reach and serve the most vulnerable people in the population-- 
women and children living in rural, isolated areas of the country. 
 
¶4. (U) The training course included various sessions ranging from 
professional competency of the trainers, technical state-of-the-art 
knowledge of primary health care delivery to community collaboration an 
supervisory skills. The session concluded March 24 with a ceremony, 
attended by Ambassador and USAID Representative, and the issuance of 
diplomas to those who completed the course.  The trainers will return t 
their districts to begin preparations for organizing local training 
courses for health clinic workers, taking with them the training 
materials they received during the course. 
 
¶5. (U)  Comment: The USAID implementation team in conjunction with the 
National Health Training Center team, spent a great deal of time 
preparing the training manuals, which would be used for this course as 
well as those that will accompany the new trainers to their rural 
districts. The weeklong course by an experienced training team was both 
well-organized and well-attended.  We note that the majority of 
trainers were male.  We hope that when they return to their respective 
districts, there will be women in their training groups, since delivery 
of ante-natal services for pregnant women as well as delivery of babies 
are among the most important functions of the rural health clinics. It 
would be very difficult in traditional, rural Islamic communities for 
women to receive health care services from an exclusively male staff. 
The USAID implementation team has as one of its tasks, to ask that the 
Ministry of Health require each rural health clinic to have at least on 
Mid-Wife, who would be responsible for delivery of all health care 
services to women. This key factor will be monitored throughout the 
project implementation.  End comment. 
RAGSDALE