The impact of the Safer Anaesthesia from Education (SAFE) Obstetric Anaesthesia training course in Ethiopia: A mixed methods longitudinal cohort study

Moore, Jolene; Morriss, Wayne W.; Asfaw, Gebrehiwot; Tesfaye, Gosa; Ahmed, Aaliya R; Walker, Isabeau

doi:10.1177/0310057x20940330

Cited by 10 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar results of SAFE courses have been published from two different regions of Ethiopia [ 33 ]. As the SAFE initiative expands, other models of training and are being developed.…”

Section: Effective Training Programs In Lmicsupporting

confidence: 84%

“…Since the first course in 2011, 104 SAFE-OB courses have taken place in 40 countries, and nearly 3244 anaesthesia providers and 581 trainers have been trained [ 33 ].…”

Section: Effective Training Programs In Lmicmentioning

confidence: 99%

“…As the SAFE initiative expands, other models of training and are being developed. SAFE-OB refreshers have recently been done in Tanzania [ 33 ].…”

Section: Effective Training Programs In Lmicmentioning

confidence: 99%

See 2 more Smart Citations

Teaching and Learning Obstetric Anaesthesia in Low- and Middle-Income Countries: Current Situation and Perspectives

Guasch

Brogly²,

Gilsanz

2023

Curr Anesthesiol Rep

View full text Add to dashboard Cite

Purpose of Review Our goal in this review is to describe the current context and peculiarities of obstetric anaesthesia in low- and middle-income countries (LMIC) and the ongoing actions and perspectives in terms of teaching and learning, focusing on improving maternal outcomes. Recent Findings Correct identification of barriers and lack of infrastructures and anaesthesia providers are still major problems despite efforts of different stakeholders. International consensus and commitment for 2030 goals are trying to be achieved. Summary Structured training courses look a good option as short- and long-term evaluations show a positive impact. Future efforts will have to be also focused on indicators that may help to decrease the high mortality and morbidity ratios in LMIC

show abstract

“…Similar results of SAFE courses have been published from two different regions of Ethiopia [ 33 ]. As the SAFE initiative expands, other models of training and are being developed.…”

Section: Effective Training Programs In Lmicsupporting

confidence: 84%

“…Since the first course in 2011, 104 SAFE-OB courses have taken place in 40 countries, and nearly 3244 anaesthesia providers and 581 trainers have been trained [ 33 ].…”

Section: Effective Training Programs In Lmicmentioning

confidence: 99%

See 1 more Smart Citation

Teaching and Learning Obstetric Anaesthesia in Low- and Middle-Income Countries: Current Situation and Perspectives

Guasch

Brogly²,

Gilsanz

2023

Curr Anesthesiol Rep

View full text Add to dashboard Cite

show abstract

“…The value of short courses such as SAFE-OB and the sustainability of its impact in these settings have been scrutinised [10]. Previous studies of SAFE courses have demonstrated retention of skills and knowledge and, through qualitative methods, have reported change in practice and impact at a system level [11][12][13][14][15]. However, no study to date has performed Kirkpatrick Level-3 evaluations to assess the degree to which SAFE course participants apply what they have learnt to their daily job [16].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of practice change following SAFE obstetric courses in Tanzania: a prospective cohort study

et al. 2023

View full text Add to dashboard Cite

SummaryAnaesthesia has been shown to contribute disproportionately to maternal mortality in low‐resource settings. This figure exceeds 500 per 100,000 live births in Tanzania, where anaesthesia is mainly provided by non‐physician anaesthetists, many of whom are working as independent practitioners in rural areas without any support or opportunity for continuous medical education. The three‐day Safer Anaesthesia from Education (SAFE) course was developed to address this gap by providing in‐service training in obstetric anaesthesia to improve patient safety. Two obstetric SAFE courses with refresher training were delivered to 75 non‐physician anaesthetists in the Mbeya region of Tanzania between August 2019 and July 2020. To evaluate translation of knowledge into practice, we conducted direct observation of the SAFE obstetric participants at their workplace in five facilities using a binary checklist of expected behaviours, to assess the peri‐operative management of patients undergoing caesarean deliveries. The observations were conducted over a 2‐week period at pre, immediately post, 6‐month and 12‐month post‐SAFE obstetric training. A total of 320 cases completed by 35 participants were observed. Significant improvements in behaviours, sustained at 12 months after training included: pre‐operative assessment of patients (32% (pre‐training) to 88% (12 months after training), p < 0.001); checking for functioning suction (73% to 85%, p = 0.003); using aseptic spinal technique (67% to 100%, p < 0.001); timely administration of prophylactic antibiotics (66% to 95%, p < 0.001); and checking spinal block adequacy (32% to 71%, p < 0.001). Our study has demonstrated positive sustained changes in the clinical practice amongst non‐physician anaesthetists as a result of SAFE obstetric training. The findings can be used to guide development of a checklist specific for anaesthesia for caesarean section to improve the quality of care for patients in low‐resource settings.

show abstract

“…The SAFE courses focus on obstetric and paediatric anaesthesia [12], and are predominantly focused on pre-and intra-operative care. Follow-up from SAFE courses suggests that these improve skills, confidence and the teamwork abilities of participants [13][14][15][16]. More recently a multidisciplinary course on operating room care [17] has been developed by WFSA; the Association of Anaesthetists; Lifebox Foundation; Royal College of Surgeons of England; Association for Peri-operative Practice; and the Royal College of Obstetricians and Gynaecologists.…”

Section: Introductionmentioning

confidence: 99%

Priorities for content for a short‐course on postoperative care relevant for low‐ and middle‐income countries: an e‐Delphi process with training facilitators

Hermes¹,

Chakravarthy²,

Vries³

et al. 2022

Anaesthesia

View full text Add to dashboard Cite

Most surgical and anaesthetic mortality and morbidity occurs postoperatively, disproportionately affecting lowand middle-income countries. Various short courses have been developed to improve patient outcomes in lowand middle-income countries, but none specifically to address postoperative care and complications. We aimed to identify key features of a proposed short-course addressing this topic using a Delphi process with lowand middle-income country anaesthesia providers trained as short-course facilitators. An initial questionnaire was co-developed from literature review and exploratory workshops to include 108 potential course features. Features included content; teaching method; appropriate participants; and appropriate faculty. Over three Delphi rounds (panellists numbered 86, 64 and 35 in successive cycles), panellists indicated which features they considered most important. Responses were analysed by geographical regions: Africa, the Americas, southeast Asia and Western Pacific. Ultimately, panellists identified 60, 40 and 54 core features for the proposed course in each region, respectively. There were high levels of consensus within regions on what constituted core course content, but not between regions. All panellists preferred the small group workshop teaching method irrespective of region. All regions considered anaesthetists to be key facilitators, while all agreed that both anaesthetists and operating theatre nurses were key participants. The African and Americas regional panels recommended more multidisciplinary healthcare professionals for participant roles. Faculty from high-income countries were not considered high priority. Our study highlights variability between geographical regions as to which course features were perceived as most locally relevant, supporting regional adaptation of short-course design rather than a one-size-fits-all model.

show abstract

The impact of the Safer Anaesthesia from Education (SAFE) Obstetric Anaesthesia training course in Ethiopia: A mixed methods longitudinal cohort study

Cited by 10 publications

References 23 publications

Teaching and Learning Obstetric Anaesthesia in Low- and Middle-Income Countries: Current Situation and Perspectives

Teaching and Learning Obstetric Anaesthesia in Low- and Middle-Income Countries: Current Situation and Perspectives

Evaluation of practice change following SAFE obstetric courses in Tanzania: a prospective cohort study

Priorities for content for a short‐course on postoperative care relevant for low‐ and middle‐income countries: an e‐Delphi process with training facilitators

Contact Info

Product

Resources

About