Evaluation of the feasibility of the FAST-M maternal sepsis intervention in Pakistan, a protocol

Abstract

Background Maternal sepsis is a life-threatening condition, defined by organ dysfunction caused by infection during pregnancy, childbirth and the postpartum period. It is estimated to account for between one tenth and half of all maternal deaths globally. An international stake-holder group, including the World Health Organization, developed a maternal sepsis management bundle called “FAST-M” for resource limited settings through a synthesis of evidence and international consensus. The FAST-M treatment bundle consists of five components: Fluids, Antibiotics, Source identification and control, assessment of the need to Transport or Transfer to a higher level of care and ongoing Monitoring (of the mother and neonate). This study aims to adapt the FAST-M intervention and evaluate its feasibility in Pakistan. Methods The proposed study is a mixed method, with a before and after design. The study will be conducted in two phases at Liaquat University of Medical and Health Sciences, Hyderabad. In the first phase, we will adapt the bundle care tools for the local context and assess in what circumstances different components of the intervention are likely to be effective, by conducting interviews and a focus group discussion (the Adaptation Phase). In the second phase, we will evaluate the feasibility of the FAST-M intervention (the Feasibility Assessment Phase). Discussion The utilisation of bundles can facilitate recognition and timely management of maternal sepsis. There is a need to adapt, integrate and optimise a bundled care approach in low-resource settings in Pakistan to minimise the burden of maternal morbidities and mortalities due to sepsis.