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A mixed methods evaluation of Advanced Life Support in Obstetrics (ALSO) and Basic Life Support in Obstetrics (BLSO) in a resource-limited setting on the Thailand-Myanmar border.

التفاصيل البيبلوغرافية
العنوان: A mixed methods evaluation of Advanced Life Support in Obstetrics (ALSO) and Basic Life Support in Obstetrics (BLSO) in a resource-limited setting on the Thailand-Myanmar border.
المؤلفون: McGready R; Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, 63110, Thailand.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LG, UK., Rijken MJ; Utrecht University Medical Centre, Utrecht University, Utrecht, Utrecht, 3584 CX, The Netherlands.; Julius Centre Global Health, University Medical Center, Utrecht, Utrecht, 3508 GA, The Netherlands., Turner C; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LG, UK.; Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia., Than HH; Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, 63110, Thailand., Tun NW; Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, 63110, Thailand., Min AM; Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, 63110, Thailand., Hla S; Reproductive Health, Mae Tao Clinic, Mae Sot, 63110, Thailand., Wai NS; Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, 63110, Thailand., Proux K; Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, 63110, Thailand., Min TH; Shoklo Malaria Research Unit, , Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Tak, 63110, Thailand., Gilder ME; Department of Family Medicine, Faculty of Medicine, Chiang Mai University,, Chiang Mai, Chiang Mai, 50200, Thailand., Sneddon A; School of Medicine, Gold Coast campus, Griffith University, Queensland, 4222, Australia.
المصدر: Wellcome open research [Wellcome Open Res] 2021 Jun 28; Vol. 6, pp. 94. Date of Electronic Publication: 2021 Jun 28 (Print Publication: 2021).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wellcome Trust Country of Publication: England NLM ID: 101696457 Publication Model: eCollection Cited Medium: Print ISSN: 2398-502X (Print) Linking ISSN: 2398502X NLM ISO Abbreviation: Wellcome Open Res Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [London] : Wellcome Trust, [2016]-
مستخلص: Background: Short emergency obstetric care (EmOC) courses have demonstrated improved provider confidence, knowledge and skills but impact on indicators such as maternal mortality and stillbirth is less substantial. This manuscript evaluates Advanced Life Support in Obstetrics (ALSO) and Basic Life Support (BLSO) as an adult education tool, in a protracted, post-conflict and resource-limited setting. Methods: A mixed methods evaluation was used. Basic characteristics of ALSO and BLSO participants and their course results were summarized. Kirkpatrick's framework for assessment of education effectiveness included: qualitative data on participants' reactions to training (level 1); and quantitative health indicator data on change in the availability and quality of EmOC and in maternal and/or neonatal health outcomes (level 4), by evaluation of the post-partum haemorrhage (PPH) related maternal mortality ratio (MMR) and stillbirth rate in the eight years prior and following implementation of ALSO and BLSO. Results: 561 Thailand-Myanmar border health workers participated in ALSO (n=355) and BLSO (n=206) courses 2008-2020. Pass rates on skills exceeded 90% for both courses while 50% passed the written ALSO test. Perceived confidence significantly improved for all items assessed. In the eight-year block preceding the implementation of ALSO and BLSO (2000-07) the PPH related MMR per 100,000 live births was 57.0 (95%CI 30.06-108.3)(9/15797) compared to 25.4 (95%CI 11.6-55.4)(6/23620) eight years following (2009-16), p=0.109. After adjustment, PPH related maternal mortality was associated with birth before ALSO/BLSO implementation aOR 3.825 (95%CI 1.1233-11.870), migrant (not refugee) status aOR 3.814 (95%CI 1.241-11.718) and attending ≤four antenatal consultations aOR 3.648 (95%CI 1.189-11.191). Stillbirth rate per 1,000 total births was 18.2 (95%CI 16.2-20.4)(291/16016) before the courses, and 11.1 (95%CI 9.8-12.5)(264/23884) after, p=0.038. Birth before ALSO/ BLSO implementation was associated with stillbirth aoR 1.235 (95%CI 1.018-1.500). Conclusions: This evaluation suggests ALSO and BLSO are sustainable, beneficial, EmOC trainings for adult education in protracted, post-conflict, resource-limited settings.
Competing Interests: No competing interests were disclosed.
(Copyright: © 2021 McGready R et al.)
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust
فهرسة مساهمة: Keywords: Adult education; Kirkpatrick’s framework; advanced life support in obstetrics training; maternal mortality; post-conflict; post-partum haemorrhage; resource-limited setting; self-confidence; stillbirth
تواريخ الأحداث: Date Created: 20210707 Latest Revision: 20210708
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC8204190.2
DOI: 10.12688/wellcomeopenres.16599.2
PMID: 34195384.2. Version: 2. Publisher Version ID: 2. Version Date: 2021/06/28
قاعدة البيانات: MEDLINE
الوصف
تدمد:2398-502X
DOI:10.12688/wellcomeopenres.16599.2