PRONTO training for obstetric and neonatal emergencies in Mexico

Walker, Dilys; Cohen, Susanna R.; Estrada, Fátima; Monterroso, Marcia E.; Jenny, Alisa; Fritz, Jimena; Fahey, Jenifer

doi:10.1016/j.ijgo.2011.09.021

Cited by 47 publications

(52 citation statements)

References 19 publications

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“…PRONTO simulation training was developed and piloted in Mexico in 2009 in response to a need for affordable, appropriate, and effective obstetric and neonatal emergency training 21. The impact of the course on patient outcomes, however, remains unevaluated.…”

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confidence: 99%

Impact Evaluation of PRONTO Mexico

Walker

Cohen

Fritz³

et al. 2016

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare

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mentioning

confidence: 99%

Impact Evaluation of PRONTO Mexico

Walker

Cohen

Fritz³

et al. 2016

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare

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“…[32] However, since the intervention was randomized, we expect the distribution of these covariates to be balanced between intervention and control groups. Additionally any remaining time-invariant confounders that failed to be equally distributed between arms by means of the matching and the randomization, were likely controlled by the Difference-in-Differences approach, [27] leaving little room for bias. A final important limitation is that this study was conducted in very particular settings within Mexico, which may yield these results not generalizable to other settings in the country or abroad.…”

Section: Discussionmentioning

confidence: 99%

“…[27] The PRONTO training in Mexico consists of 2 Modules: Module I includes: (a) a facilitated dialogue around humanized birth, patient communication and evidence based-practices (AMTSL, DCC, SSC, episiotomy, fundal pressure, uterine sweeping); (b) teamwork and communication; and (c) emergency management simulations and skills-stations focusing on obstetric hemorrhage and neonatal resuscitation). Module II (2 to 3 months after Module I) reinforces Module I themes and adds shoulder dystocia and preeclampsia/eclampsia.…”

Section: Methodsmentioning

confidence: 99%

Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico

Fritz¹,

Walker²,

Cohen

et al. 2017

PLoS ONE

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BackgroundIn Mexico, although the majority of births are attended in hospitals, reports have emerged of obstetric violence, use of unsafe practices, and failure to employ evidence-based practices (EBP). Recent attention has refocused global efforts towards provision of quality care that is both patient-centered and evidence-based. Scaling up of local interventions should rely on strong evidence of effectiveness.ObjectiveTo perform a secondary analysis to evaluate the impact of a simulation and team-training program (PRONTO) on the performance of EBP in normal births.MethodsA pair-matched cluster randomized controlled trial of the intervention was designed to measure the impact of the program (PRONTO intervention) on a sample of 24 hospitals (12 hospitals received the PRONTO training and 12 served as controls) in the states of Chiapas, Guerrero, and Mexico. We estimated the impact of receiving the intervention on the probability of birth practices performance in a sample of 641 observed births of which 318 occurred in the treated hospitals and 323 occurred in control hospitals. Data was collected at 4 time points (baseline, 4th, 8th and 12th months after the training). Women were blinded to treatment allocation but observers and providers were not. Estimates were obtained by fitting difference-in-differences logistic regression models considering confounding variables. The trial is registered at clinicaltrials.gov: # NCT01477554.ResultsSignificant changes were found following the intervention. At 4 months post-intervention an increase of 20 percentage points (p.p.) for complete Active Management of Third Stage of Labor (AMTSL) (p = 0.044), and 16 p.p. increase for Skin-to-Skin Contact (p = 0.067); at 12 months a 25 p.p. increase of the 1st step of AMTSL (p = 0.026) and a 42 p.p. increase of Delayed Cord Clamping (p = 0.004); at 4 months a 30 (p = 0.001) and at 8 months a 22 (p = 0.010) p.p. decrease for Uterine Sweeping.ConclusionsThe intervention has an impact on adopting EBP at birth, contributing to an increased quality of care. Long lasting impacts on these practices are possible if there were to be a widespread adoption of the training techniques including simulation, team-training and facilitated discussions regarding routine care.

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“…EmONC training courses designed specifically for a low-resource country setting include the CMNH-LSTM EmONC training course [23,45,46,61], ESMOE [47], PRONTO [48], ESS-EMNH [44], the Pacific Emergency Obstetric Course (PEOC), HBB and HMS-BAC. However, only few of these training packages have content that covers all the emergency obstetric and newborn care signal functions.…”

Section: Indicatormentioning

confidence: 99%

Making It Happen: Training health-care providers in emergency obstetric and newborn care

Ameh

Broek

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

102

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An estimated 289,000 maternal deaths, 2.6 million stillbirths and 2.4 million newborn deaths occur globally each year, with the majority occurring around the time of childbirth. The medical and surgical interventions to prevent this loss of life are known, and most maternal and newborn deaths are in principle preventable. There is a need to build the capacity of health-care providers to recognize and manage complications during pregnancy, childbirth and the post-partum period. Skills-and-drills competency-based training in skilled birth attendance, emergency obstetric care and early newborn care (EmONC) is an approach that is successful in improving knowledge and skills. There is emerging evidence of this resulting in improved availability and quality of care. To evaluate the effectiveness of EmONC training, operational research using an adapted Kirkpatrick framework and a theory of change approach is needed. The Making It Happen programme is an example of this.

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PRONTO training for obstetric and neonatal emergencies in Mexico

Cited by 47 publications

References 19 publications

Impact Evaluation of PRONTO Mexico

Impact Evaluation of PRONTO Mexico

Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico

Making It Happen: Training health-care providers in emergency obstetric and newborn care

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