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

doi:10.1016/j.ijgo.2014.05.023

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 journal › Article › peer-review

23 Citations (Scopus)

Abstract

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 language	English
Pages (from-to)	189-193
Number of pages	5
Journal	International Journal of Gynecology and Obstetrics
Volume	127
Issue number	2
DOIs	https://doi.org/10.1016/j.ijgo.2014.05.023
Publication status	Published - 1 Nov 2014
Externally published	Yes

Keywords

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijgo.2014.05.023

Cite this

Spitzer, R. F., Steele, S. J., Caloia, D., Thorne, J., Bocking, A. D., Christoffersen-Deb, A., Yarmoshuk, A., Maina, L., Sitters, J., Chemwolo, B., & Omenge, E. (2014). One-year evaluation of the impact of an emergency obstetric and neonatal care training program in Western Kenya. International Journal of Gynecology and Obstetrics, 127(2), 189-193. https://doi.org/10.1016/j.ijgo.2014.05.023

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abstract = "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.",

keywords = "Emergency obstetric and neonatal care (EmONC), Evaluation, Maternal morbidity, Maternal mortality, Obstetrics, Training",

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

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Spitzer, RF, Steele, SJ, Caloia, D, Thorne, J, Bocking, AD, Christoffersen-Deb, A, Yarmoshuk, A, Maina, L, Sitters, J, Chemwolo, B & Omenge, E 2014, 'One-year evaluation of the impact of an emergency obstetric and neonatal care training program in Western Kenya', International Journal of Gynecology and Obstetrics, vol. 127, no. 2, pp. 189-193. https://doi.org/10.1016/j.ijgo.2014.05.023

TY - JOUR

T1 - One-year evaluation of the impact of an emergency obstetric and neonatal care training program in Western Kenya

AU - Spitzer, Rachel F.

AU - Steele, Sarah Jane

AU - Caloia, David

AU - Thorne, Julie

AU - Bocking, Alan D.

AU - Christoffersen-Deb, Astrid

AU - Yarmoshuk, Aaron

AU - Maina, Loise

AU - Sitters, Johanna

AU - Chemwolo, Benjamin

AU - Omenge, Elkanah

PY - 2014/11/1

Y1 - 2014/11/1

N2 - 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.

AB - 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.

KW - Emergency obstetric and neonatal care (EmONC)

KW - Evaluation

KW - Maternal morbidity

KW - Maternal mortality

KW - Obstetrics

KW - Training

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DO - 10.1016/j.ijgo.2014.05.023

M3 - Article

C2 - 25124101

AN - SCOPUS:84908071137

SN - 0020-7292

VL - 127

SP - 189

EP - 193

JO - International Journal of Gynecology and Obstetrics

JF - International Journal of Gynecology and Obstetrics

IS - 2

ER -

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

Abstract

Keywords

UN SDGs

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