The impact of emergency obstetric care training in Somaliland, Somalia

Ameh, Charles; Adegoke, Adetoro A.; Hofman, Jan; Ismail, Fouzia Mohamed; Ahmed, Fatuma M.; Broek, Nynke van den

doi:10.1016/j.ijgo.2012.01.015

Cited by 61 publications

(95 citation statements)

References 17 publications

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“…Thirteen studies had been conducted in [19][20][21][22][23][24][25][26][27][28] 6 DH (L2&L3) -HIC 10 RCT 2a,b,c 3b NHS Foundation Trust, Liverpool, UK [44,45] --HIC 1 Before-after 4b,c Victoria, Australia [46] 7 [48] --LMIC 1 Before-after 1 2b −−− −−− Sub-Saharan Africa (7 countries) [49] --LMIC 1 Before-after 1 2b,c −−− −−− Somaliland, Somalia [50] 3 8 LMIC 1 Before-after 1 2b,c 3a 4b Making it Happen, Bangladesh & India [52] 4 DH (Bangl.) [54] 3 DH; 3 FH 40 LMIC 1 Quasi-experimental 3c CRM based National study, US [58] 15 -HIC 1 RCT 4c Beth Israel Deaconness Medical Center, US [59] 1 TTH -HIC 1 Before-after 2a 4b,c Perinatal Safety Initiative, US [60] 1 TH -HIC 1 Before-after 3a 4b,c Rhode Island Hospital, US [61] 1 -HIC 1 Before-after 4b,c Geneva University Hospital, Switzerland [63] 1 TTH -HIC 1 Before-after 1 2a 3a TeamSTEPPS, US [18] 3 CH -HIC 1 RCT 2a 4c OBCTT, Southeast US [62] 1 TTH -HIC 1 Quasi-experimental before-after 1 2a,b,c −−− −−− OTHER CEmONC, Tanzania [17] 1 DH LMIC 1 Before-after 3c Copenhagen University Hospital, Denmark [64] 1 TTH -HIC 1 Before-after 1 2a,b 3a 4b University of Oporto, Portugal [65] 1 TTH -HIC 1 Before-after 1 2b 3a * In progress -abstracts not included [31,32] DH = district hospital L1 = level 1 −−− = studies not going beyond Kirkpatrick level 2 RH = referral hospital L2 = level 2 (secondary/regional) FH = field hospital TH = tertiary hospital/medical centre L3 = level 3 (tertiary) CH = community hospital TTH = tertiary and teaching hospital included in the studies spans the whole spectrum from tertiary teaching hospitals to community-and field hospitals.…”

Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

“…A number of studies in the literature reviewed indicated how their authors had evaluated their own programmes according to the four levels of training achievements described by Kirkpatrick [11,14,19,50,63,64,68,76]. The first two levels refer to the reaction of training participants (satisfaction after training) and the knowledge and skills learning of the trainee.…”

Section: The Kirkpatrick Classification Of Evaluating Training Programmementioning

confidence: 99%

“…Policies enabling or supporting the implementation of EMONC training packages are essential [33,50,69,83], as well as supportive work environments and across-the-board participation at all levels of the health system [39]. Choosing realistic low-tech training equipment may facilitate onsite training because of a more equal distribution of available resources that can enable more appropriate training for a greater number of healthcare workers.…”

Section: Future Agendamentioning

confidence: 99%

See 2 more Smart Citations

What is the impact of multi-professional emergency obstetric and neonatal care training?

Bergh

Baloyi

Pattinson

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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This paper reviews evidence regarding change in healthcare-provider behaviour and maternal and neonatal outcomes as a result of emergency obstetric and neonatal care (EmONC) training. A refined version of the Kirkpatrick classification for programme evaluation was used to focus on change in efficiency and impact of training (levels 3 and 4). Twenty-three studies were reviewed -5 randomised controlled trials, 2 quasi-experimental studies and 16 before-and-after observational studies. Training programmes had all been developed in highincome countries and adapted for use in low-and middle-income countries. Nine studies reported on behaviour change and 13 on process and patient outcomes. Most showed positive results. Every maternity unit should provide EmONC teamwork training, mandatory for all healthcare providers. The challenges are: scaling up such training to all institutions; sustaining regular in-service training; integrating training into institutional and health-system patient-safety initiatives; and 'thinking-out-of-the-box' in evaluation research.

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Section: Synopsis Of Peer-reviewed Articles Included In the Reviewmentioning

confidence: 99%

Section: The Kirkpatrick Classification Of Evaluating Training Programmementioning

confidence: 99%

Section: Future Agendamentioning

confidence: 99%

See 1 more Smart Citation

What is the impact of multi-professional emergency obstetric and neonatal care training?

Bergh

Baloyi

Pattinson

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

View full text Add to dashboard Cite

show abstract

“…[28] These study findings concur with the results of previous research on similar CPD education programs which reported increased knowledge, skills, and confidence among participants in obstetric emergency management. [28,29] The midwives perceived that maternal deaths decreased after having participated in an ALSO R course. Participants' perceptions of the reduction of maternal deaths might be attributed to their improved ability to prevent and manage PPH, avoidance of performing unnecessary episiotomies, and improved inter-professional team work.…”

Section: Discussionmentioning

confidence: 99%

“…Similar results were demonstrated in a study conducted in Somalia to assess the impact of in-service education programs on emergency obstetric care, where 90% of participants were nurses and midwives The findings showed that lack of drugs, materials and essential equipment, and discouraging policies were barriers which hampered the translation of new knowledge and skills acquired into practice. [29] In the field of maternal and newborn health services, the shortage of skilled birth attendants and limited materials and equipment are critical barriers to availability of quality emergency obstetric care in low and middle resource countries. [30,31] Inadequate implementation of evidence-based interventions to reduce maternal and newborn mortality in limited resource settings is primarily due to lack of resources.…”

Section: Discussionmentioning

confidence: 99%

Midwives’ experience of participating in the Advanced Life Support in Obstetrics® educational program in Rwanda

Uwajeneza

Babenko-Mould

Evans

et al. 2015

JNEP

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High maternal and newborn mortality rates remain a global health issue. Ninety-nine percent of maternal deaths occur in low and middle income countries and many could be prevented by having more qualified health providers. In 2013, 62% of maternal deaths took place in Sub-Saharan Africa. The Advanced Life Support in Obstetrics (ALSO R ) Educational Program is an internationally recognized continuous professional development course aimed at increasing the knowledge, skills, competence, and confidence of health professionals to manage obstetric emergencies. The purpose of this qualitative descriptive study was to explore midwives' experiences of translating the knowledge and skills acquired from participating in the ALSO R program into their professional practice in Rwanda. A purposive sample of nine midwives participated in one-to-one interviews directed at understanding their experience of implementing their new knowledge and skills into practice. All interviews were audio-recorded and transcribed verbatim. Content analysis was used to illuminate five themes: 1) Improved midwifery practice, 2) Availability of resources, 3) Inter-professional collaboration, 4) Job (dis)satisfaction, and 5) Autonomy for midwifery practice. The findings revealed that although midwives reported increased knowledge, skills and confidence in management of obstetric emergencies, their ability to change practice was often hampered by non-conducive work environments, a shortage of health care providers, and insufficient equipment and materials. These findings can serve to inform ALSO R course module development, midwifery education development, and health human resources policy that can address obstetrical and newborn education needs and health service delivery in Rwanda.

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Skilled Birth Attendants in Tanzania: A Descriptive Study of Cadres and Emergency Obstetric Care Signal Functions Performed

Ueno

Adegoke

Masenga

et al. 2014

Matern Child Health J

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Although most developing countries monitor the proportion of births attended by skilled birth attendants (SBA), they lack information on the availability and performance of emergency obstetric care (EmOC) signal functions by different cadres of health care providers (HCPs). The World Health Organisation signal functions are set of key interventions that targets direct obstetric causes of maternal deaths. Seven signal functions are required for health facilities providing basic EmOC and nine for facilities providing comprehensive EmOC. Our objectives were to describe cadres of HCPs who are considered SBAs in Tanzania, the EmOC signal functions they perform and challenges associated with performance of EmOC signal functions. We conducted a cross-sectional study of HCPs offering maternity care services at eight health facilities in Moshi Urban District in northern Tanzania. A questionnaire and health facility assessment forms were used to collect information from participants and health facilities. A total of 199 HCPs working at eight health facilities in Moshi Urban District met the inclusion criteria. Out of 199, 158 participated, giving a response rate of 79.4 %. Ten cadres of HCPs were identified as conducting deliveries regardless of the level of health facilities. Most of the participants (81 %) considered themselves SBAs, although some were not considered SBAs by the Ministry of Health and Social Welfare (MOHSW). Only two out of the eight facilities provided all of the required EmOC signal functions. While Assistant Medical Officers are expected to perform all the signal functions, only 38 % and 13 % had performed vacuum extraction or caesarean sections respectively. Very few registered and enrolled nurse-midwives had performed removal of retained products (22 %) or assisted vaginal delivery (24 and 11 %). Inadequate equipment and supplies, and lack of knowledge and skills in performing EmOC were two main challenges identified by health care providers in all the level of care. In the district, gaps existed between performance of EmOC signal functions by SBAs as expected by the MOHSW and the actual performance at health facilities. All basic EmOC facilities were not fully functional. Few health care providers performed all the basic EmOC signal functions. Competency-based in-service training of providers in EmOC and provision of enabling environment could improve performance of EmOC signal functions in the district.

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The impact of emergency obstetric care training in Somaliland, Somalia

Abstract: The training impacted positively on the availability and quality of EmOC and resulted in "up-skilling" of midwives.

Cited by 61 publications

References 17 publications

What is the impact of multi-professional emergency obstetric and neonatal care training?

What is the impact of multi-professional emergency obstetric and neonatal care training?

Midwives’ experience of participating in the Advanced Life Support in Obstetrics® educational program in Rwanda

Skilled Birth Attendants in Tanzania: A Descriptive Study of Cadres and Emergency Obstetric Care Signal Functions Performed

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