| Title |
Reintroducing vacuum extraction in primary health care facilities: a case study from Tanzania
|
|---|---|
| Published in |
BMC Pregnancy and Childbirth, June 2018
|
| DOI | 10.1186/s12884-018-1888-9 |
| Pubmed ID | |
| Authors |
Sunday Dominico, Patricia E. Bailey, Nguke Mwakatundu, Mkambu Kasanga, Jos van Roosmalen |
| Abstract |
In rural Tanzania access to emergency obstetric and newborn care is threatened by poor roads and understaffed facilities among other challenges. Districts in Kigoma, Pwani and Morogoro regions were targeted by a local non-governmental organization to assist local government to build capacity and improve access to clinical management of severe obstetric and newborn complications. The program upgraded ten primary health care centres to provide comprehensive emergency obstetric and newborn care. This paper describes the process of reintroducing vacuum extraction into ten health centres and five hospitals, highlighting patterns in uptake, mode of delivery and lessons learned. This observational study uses facility-based trend data collected between 2011 and 2016.Descriptive outcomes include institutional caesarean delivery rates, vacuum extraction rates, and the ratio of caesareans to vacuum-assisted deliveries. Institutional caesarean delivery rates remained stable at about 10-11% and the vacuum extraction rate rose from virtually no procedures in 2011 to about 2% in 2016. The increase was more visible in upgraded health centres than in hospitals. In 2016 vacuum extraction rates in newly upgraded health centres ranged from 0.5 to 7.8%. Between 2011 and 2016, the ratio of caesareans to vacuum extractions in hospitals changed from 304 caesareans to 1 vacuum extraction to 10:1, while in health centres the ratio changed from 22: 1 to 3: 1. Reintroduction of vacuum extraction into clinical practice in primary health care facilities with task-shifting is feasible. Reintroduction of this procedure was more successful when part of an integrated upgrading of health centres to provide comprehensive emergency obstetric care than when reintroduced into busy hospital environments. Turnover of trained staff in hospitals contributed to the uneven uptake of vacuum extraction. Lessons learned are applicable to further national scale up and to other countries. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 70 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 70 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 11% |
| Researcher | 7 | 10% |
| Student > Ph. D. Student | 6 | 9% |
| Student > Bachelor | 6 | 9% |
| Student > Postgraduate | 5 | 7% |
| Other | 14 | 20% |
| Unknown | 24 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 19 | 27% |
| Nursing and Health Professions | 10 | 14% |
| Social Sciences | 6 | 9% |
| Business, Management and Accounting | 2 | 3% |
| Engineering | 2 | 3% |
| Other | 8 | 11% |
| Unknown | 23 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 June 2018.
All research outputs
#3,792,989
of 23,090,520 outputs
Outputs from BMC Pregnancy and Childbirth
#1,019
of 4,251 outputs
Outputs of similar age
#74,155
of 328,030 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#42
of 142 outputs
Altmetric has tracked 23,090,520 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,251 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.9. This one has done well, scoring higher than 75% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 328,030 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 77% of its contemporaries.
We're also able to compare this research output to 142 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 66% of its contemporaries.