This clinical trial's primary goal is to compare birth attendants' competencies. It aims to answer the questions:

• Does the new modular training package enhance the competencies of skilled birth attendants?
• Does the competencies of skilled birth attendants relates to improving maternal and neonatal health outcomes in Nepal?
• Is this training module a cost-effective intervention?

Participants' knowledge, attitude, and skills will be assessed and it will be compared with standard training groups: Researchers will compare the competencies of birth attendants who receive modular training versus standard training to see if an increment in competencies is associated with maternal and neonatal health outcomes.

Inclusion Criteria:

• Health workers should be Auxiliary Nurse Midwives and Nurses working in birthing centers where at least 10 birth managed in the last year
• Health workers (Auxiliary Nurse Midwives and Nurses) who are committed to providing maternal and neonatal health services and priority for permanent service holders.
• Who passes at least the first module (Online module) to participate in modular training

Exclusion Criteria:

• Health workers (Auxiliary Nurse Midwives ad Nurses) who do not provide maternal and neonatal health service
• Health workers other than Auxiliary Nurse Midwives and Nurses though they provide maternal neonatal health services in government health facilities
• Health workers working in private health facilities

The outcomes assessor and care provider will be masked to minimize the biases. Trainers will be outcomes assessors and trainees who complete modular training and provide maternal and child health services are considered as care providers.