Title |
Onsite training of doctors, midwives and nurses in obstetric emergencies, Zimbabwe
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Published in |
Bulletin of the World Health Organization, March 2015
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DOI | 10.2471/blt.14.145532 |
Pubmed ID | |
Authors |
Joanna F Crofts, Teclar Mukuli, Bobb T Murove, Solwayo Ngwenya, Sma Mhlanga, Meluleki Dube, Elton Sengurayi, Cathy Winter, Sharon Jordan, Sonia Barnfield, Heather Wilcox, Abi Merriel, Sabelo Ndlovu, Zedekiah Sibanda, Sikangezile Moyo, Wedu Ndebele, Tim J Draycott, Thabani Sibanda |
Abstract |
In Zimbabwe, many health facilities are not able to manage serious obstetric complications. Staff most commonly identified inadequate training as the greatest barrier to preventing avoidable maternal deaths. We established an onsite obstetric emergencies training programme for maternity staff in the Mpilo Central Hospital. We trained 12 local staff to become trainers and provided them with the equipment and resources needed for the course. The trainers held one-day courses for 299 staff at the hospital. Maternal mortality in Zimbabwe has increased from 555 to 960 per 100 000 pregnant women from 2006 to 2011 and 47% of the deaths are believed to be avoidable. Most obstetric emergencies trainings are held off-site, away from the clinical area, for a limited number of staff. Following an in-hospital train-the-trainers course, 90% (138/153) of maternity staff were trained locally within the first year, with 299 hospital staff trained to date. Local system changes included: the introduction of a labour ward board, emergency boxes, colour-coded early warning observation charts and a maternity dashboard. In this hospital, these changes have been associated with a 34% reduction in hospital maternal mortality from 67 maternal deaths per 9078 births (0.74%) in 2011 compared with 48 maternal deaths per 9884 births (0.49%) in 2014. Introducing obstetric emergencies training and tools was feasible onsite, improved clinical practice, was sustained by local staff and associated with improved clinical outcomes. Further work to study the implementation and effect of this intervention at scale is required. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 1 | <1% |
Canada | 1 | <1% |
Unknown | 175 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 33 | 19% |
Student > Ph. D. Student | 20 | 11% |
Student > Bachelor | 15 | 8% |
Researcher | 11 | 6% |
Other | 9 | 5% |
Other | 39 | 22% |
Unknown | 50 | 28% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 51 | 29% |
Nursing and Health Professions | 39 | 22% |
Social Sciences | 10 | 6% |
Psychology | 6 | 3% |
Agricultural and Biological Sciences | 6 | 3% |
Other | 11 | 6% |
Unknown | 54 | 31% |