Progress
report of “Helping Mothers Deliver – an assessment of the quality of obstetric care
and a prospective study of the impact of simulation-based training in emergency
obstetric care in a resource-limited rural hospital in Tanzania”.
Introduction
In summary my
research project is about the evaluation of the simulation-based training
“Helping Mothers Survive - Bleeding After Birth” (HMS-BAB) that will be given
in Haydom Lutheran Hospital (HLH). The evaluation will be based on the four levels
of Kirkpatrick. The first level is reaction: how do people value the
simulation-based training? Participants of the training will be assessed by
means of an evaluation form immediately after the course. The second level is
learning: How do the participants change their knowledge, skills and attitude
after training compared to before training? This will be assessed by a
knowledge and skills test and an attitude questionnaire before, immediately
after and at six months after training. The third level is behaviour: How do
people change their behaviour in daily practice with the newly acquired
knowledge and skills? This will be assessed by prospective observations of all
deliveries that take place in HLH during 6 months before intervention and 6
months after intervention. The last level that will be addressed is the
outcome: How does training affect the outcome of the mother? This will be
assessed by both the prospective observations, but also by the maternal
morbidity and mortality data that is collected in the hospital since November
2009.
Activities of
2012
February 2012:
Visit to
Stavanger: preparation of field visit March 2012.
March 2012:
Field visit
Tanzania: Intervention with Helping Mothers Survive simulation-based training.
Pre- and post testing of knowledge, skills and confidence.
April 2012:
Conference
Safe Motherhood, Amsterdam: oral presentation about maternal morbidity and
mortality in a rural hospital in Tanzania.
May 2012:
MCHIP Conference,
Bangladesh: oral presentation about intervention with Helping Mothers Survive
simulation-based training with preliminary results of pre- and post testing of
knowledge, skills and confidence.
June 2012:
Conference
SESAM, Stavanger: oral presentation about intervention with Helping Mothers Survive
simulation-based training with results of pre- and post testing of knowledge,
skills and confidence.
July 2012:
-
Field visit Tanzania: Follow-up maternal
morbidity and mortality data collection, training research assistants. Informal
inquiries about implementation of low-dose high frequency (LDHF) implementation
of Helping Mothers Survive.
-
Submission article “Maternal Near Miss and
Mortality in a Rural Referral Hospital in Northern Tanzania: a Cross Sectional
Study” to BJOG. Rejected after review in September 2012.
October 2012:
-
FIGO Conference, Rome: oral presentation about validity of WHO near miss
criteria, poster presentation about intervention with Helping Mothers Survive
simulation-based training with results of pre- and post testing of knowledge,
skills and confidence.
-
Field visit to Tanzania (Oct-Dec 2012): 6-month post intervention testing
of retention of knowledge and skills of health care workers. Follow-up of data
collection maternal morbidity and mortality data. Training of research
assistants.
November 2012:
Submission
article “Maternal Near Miss and Mortality in a Rural Referral Hospital in
Northern Tanzania: a Cross Sectional Study” to BMC Pregnancy and Childbirth.
Article is currently under revision.
December 2012:
Submission article “Applicability of the WHO Maternal Near Miss
Criteria in a Low-Resource Setting” to PLOS one. Article is currently under
revision.
Planning 2013
-
March-August: implementation study HLH. Why did implementation of LDHF
training not succeed and how can we improve implementation of LDHF training?
This side project will be designed by Ellen Nelissen, Jacqueline Broerse and
Marleen van Overstraten, and carried out by Marleen van Overstraten in Tanzania.
-
March: Submission of paper about level 1 and 2 evaluation
-
March: Field visit Tanzania for implementation study and follow up of
maternal morbidity and mortality data collection.
-
April: Conference gynaecology & obstetrics, Rotterdam: oral
presentation validity WHO near miss criteria.
-
June: Submission paper about level 3 “behaviour change” after
simulation-based training.
-
June: SESAM conference Paris
-
Aug: Submission paper retention of knowledge and skills after
simulation-based training.
-
Oct: Submission paper about level 4 “maternal outcome” after
simulation-based training.
-
Nov/Dec: writing of PhD-thesis
-
Dec: Submission paper about implementation of LDHF training.
