One-year evaluation of the impact of an emergency obstetric and neonatal care training program in Western Kenya

Rachel F. Spitzer, Sarah Jane Steele, David Caloia, Julie Thorne, Alan D. Bocking, Astrid Christoffersen-Deb, Aaron Yarmoshuk, Loise Maina, Johanna Sitters, Benjamin Chemwolo, Elkanah Omenge

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)


Objective: To determine the impact of introducing an emergency obstetric and neonatal care training programon maternal and perinatalmorbidity andmortality atMoi Teaching and ReferralHospital, Eldoret, Kenya.

Methods: A prospective chart review was conducted of all deliveries during the 3-month period (November 2009 to January 2010) before the introduction of the Advances in Labor and RiskManagement International Program (AIP), and in the 3-month period (AugustNovember 2011) 1 year after the introduction of the AIP. All women who were admitted and delivered after 28 weeks of pregnancywere included. The primary outcome was the direct obstetric case fatality rate.

Results: A total of 1741 deliveries occurred during the baseline period and 1812 in the postintervention period. Only one mother died in each period. However, postpartum hemorrhage rates decreased, affecting 59 (3.5%) of 1669 patients before implementation and 40 (2.3%) of 1751 afterwards (P = 0.029). The number of patients who received oxytocin increased from 829 (47.6%) to 1669 (92.1%; P b 0.001). Additionally, the number of neonateswith 5-minute Apgar scores of less than 5 reduced from133 (7.7%) of 1717 to 95 (5.4%) of 1745 (P = 0.006).

Conclusion: The introduction of the AIP improved maternal outcomes. There were significant differences related to use of oxytocin and postpartum hemorrhage.

Original languageEnglish
Pages (from-to)189-193
Number of pages5
JournalInternational Journal of Gynecology and Obstetrics
Issue number2
Publication statusPublished - 1 Nov 2014
Externally publishedYes


  • Emergency obstetric and neonatal care (EmONC)
  • Evaluation
  • Maternal morbidity
  • Maternal mortality
  • Obstetrics
  • Training


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