The impact of Advanced Life Support in Obstetrics (ALSO) training in low-resource countries

Dresang, Lee T.; González, María Mercedes Ancheta; Beasley, John W.; Bustillo, Maura Carolina; Damos, Jim; Deutchman, Mark; Evensen, Ann; Ancheta, Norma González de; Rojas-Suarez, José; Schwartz, Jonathan P.; Sørensen, Bent; Winslow, Diana; Leeman, Lawrence

doi:10.1016/j.ijgo.2015.05.015

Cited by 33 publications

(30 citation statements)

References 21 publications

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“…FPs can also build interdisciplinary relationships by leading or teaching in specific maternity or team-building courses as detailed in Table 1. [17][18][19][20][21][22][23][24][25]59 Navigating Privileging Another recurring theme in the STFM workshops was privileging difficulties. FPs may struggle to get privileges approved by hospital credentialing committees because there is not a consistent national standard set of FP maternity care privileges, and requirements to obtain privileges at any individual hospital are often dependent on local or regional needs and not based on an individual provider's experience.…”

Section: Cultivating Interdisciplinary Relationshipsmentioning

confidence: 99%

Supporting Family Physician Maternity Care Providers

Goldstein

Hartman

Meunier

et al. 2018

Fam Med

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Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers. (Fam Med. 2018;50(9):662-71.)

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Section: Cultivating Interdisciplinary Relationshipsmentioning

confidence: 99%

Supporting Family Physician Maternity Care Providers

Goldstein

Hartman

Meunier

et al. 2018

Fam Med

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“…Health authorities and their development partners have implemented a variety of training courses to enhance education and health workers’ competence. Courses such as Emergency Obstetric and Newborn Care (EmONC) and Advanced Life Support in Obstetrics (ALSO) involving mid- and high-level health care providers have been established globally, including Tanzania, during the last 15-20 years [9, 10] . These courses are combining evidence-based theory and hands-on training.…”

Section: Introductionmentioning

confidence: 99%

“No patient should die of PPH just for the lack of training!” Experiences from multi-professional simulation training on postpartum hemorrhage in northern Tanzania: a qualitative study

Egenberg

Karlsen

Massay³

et al. 2017

BMC Med Educ

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BackgroundPostpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. In Tanzania, PPH causes 25% of maternal deaths. Skilled attendance is crucial to saving the lives of mothers and their newborns during childbirth.This study is a follow-up after multi-professional simulation training on PPH in northern Tanzania. The purpose was to enhance understanding and gain knowledge of important learning features and outcomes related to multi-professional simulation training on PPH.MethodsThe study had a descriptive and exploratory design. After the second annual simulation training at two hospitals in northern Tanzania, ten focus group discussions comprising 42 nurse midwives, doctors, and medical attendants, were carried out. A semi-structured interview guide was used during the discussions, which were audio-taped for qualitative content analysis of manifest content.ResultsThe most important findings from the focus group discussions were the importance of team training as learning feature, and the perception of improved ability to use a teamwork approach to PPH. Regardless of profession and job tasks, the informants expressed enhanced self-efficacy and reduced perception of stress. The informants perceived that improved competence enabled them to provide efficient PPH management for improved maternal health. They recommended simulation training to be continued and disseminated.ConclusionLearning features, such as training in teams, skills training, and realistic repeated scenarios with consecutive debriefing for reflective learning, including a systems approach to human error, were crucial for enhanced teamwork. Informants’ confidence levels increased, their stress levels decreased, and they were confident that they offered better maternal services after training.

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“…The SAFE paediatric anaesthesia course is the first Short courses are one method to address training gaps, and have shown encouraging results [7,[22][23][24]. Systematic review and meta-analysis of attendance at adult advanced cardiac life support courses have been shown to have a positive effect on patient outcomes [22].…”

Section: Discussionmentioning

confidence: 99%

The Safer Anaesthesia from Education (SAFE)^® paediatric anaesthesia course: educational impact in five countries in East and Central Africa

et al. 2019

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Summary There is an urgent need to improve access to safe surgical and anaesthetic care for children living in many low‐ and middle‐income countries. Providing quality training for healthcare workers is a key component of achieving this. The 3‐day Safer Anaesthesia from Education (SAFE)® paediatric anaesthesia course was developed to address the specific skills and knowledge required in this field. We undertook a project to expand this course across five East and Central African countries (Ethiopia, Kenya, Malawi, Uganda and Zambia) and train local faculty. This study reports the outcomes from course evaluation data, exploring the impact on knowledge, skills and behaviour change in participants. Eleven courses were conducted in a 15‐month period, with 381 participants attending. Fifty‐nine new faculty members were trained. Knowledge scores (0–50 scale) increased significantly from mean (SD) 37.5 (4.7) pre‐course to 43.2 (3.5) post‐course (p < 0.0001). Skills scores (0–10 scale) increased significantly from 5.7 (2.0) pre‐course to 8.0 (1.5) post‐course (p < 0.0001). One hundred and twenty‐six participants in Malawi, Uganda and Zambia were visited in their workplace 3–6 months later. Knowledge and skills were maintained at follow‐up, with scores of 41.5 (5.0) and 8.3 (1.4), respectively (p < 0.0001 compared with pre‐course scores). Content analysis from interviews with these participants highlighted positive behaviour changes in the areas of preparation, peri‐operative care, resuscitation, management of the sick child, communication and teaching. This study indicates that the SAFE paediatric anaesthesia course is an effective way to deliver training, and could be used to help strengthen emergency and essential surgical care for children as a component of universal health coverage.

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The impact of Advanced Life Support in Obstetrics (ALSO) training in low-resource countries

Abstract: In low-income countries, ALSO training was associated with decreased in-hospital maternal mortality, episiotomy use, and PPH. AMTSL and vacuum-assisted vaginal delivery increased in frequency after ALSO training.

Cited by 33 publications

References 21 publications

Supporting Family Physician Maternity Care Providers

Supporting Family Physician Maternity Care Providers

“No patient should die of PPH just for the lack of training!” Experiences from multi-professional simulation training on postpartum hemorrhage in northern Tanzania: a qualitative study

The Safer Anaesthesia from Education (SAFE)^® paediatric anaesthesia course: educational impact in five countries in East and Central Africa

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The impact of Advanced Life Support in Obstetrics (ALSO) training in low-resource countries

Abstract: In low-income countries, ALSO training was associated with decreased in-hospital maternal mortality, episiotomy use, and PPH. AMTSL and vacuum-assisted vaginal delivery increased in frequency after ALSO training.

Cited by 33 publications

References 21 publications

Supporting Family Physician Maternity Care Providers

Supporting Family Physician Maternity Care Providers

“No patient should die of PPH just for the lack of training!” Experiences from multi-professional simulation training on postpartum hemorrhage in northern Tanzania: a qualitative study

The Safer Anaesthesia from Education (SAFE)® paediatric anaesthesia course: educational impact in five countries in East and Central Africa

Contact Info

Product

Resources

About

The Safer Anaesthesia from Education (SAFE)^® paediatric anaesthesia course: educational impact in five countries in East and Central Africa