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The effectiveness of training in emergency obstetric care: a systematic literature review

Ameh, Charles, Mdegela, Mselenge, White, Sarah and van den Broek, Nynke (2019) The effectiveness of training in emergency obstetric care: a systematic literature review. Health Policy and Planning, 34 (4). pp. 257-270. ISSN 1460-2237

Item Type: Article

Abstract

Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the evidence for the effectiveness of training in EmOC. Eleven databases and websites were searched for publications describing EmOC training evaluations between 1997 and 2017. Effectiveness was assessed at four levels: (1) participant reaction, (2) knowledge and skills, (3) change in behaviour and clinical practice and (4) availability of EmOC and health outcomes. Weighted means for change in knowledge and skills obtained, narrative synthesis of results for other levels. One hundred and one studies including before–after studies (n¼44) and randomized controlled trials (RCTs) (n¼15). Level 1 and/or 2 was assessed in 68 studies; Level 3 in 51, Level 4 in 21 studies. Only three studies assessed effectiveness at all four levels. Weighted mean scores pre-training, and change after training were 67.0% and 10.6% for knowledge (7750 participants) and 53.1% and 29.8% for skills (6054 participants; 13 studies). There is strong evidence for improved clinical practice (adherence to protocols, resuscitation technique, communication and team work) and improved neonatal outcomes (reduced trauma after shoulder dystocia, reduced number of babies with hypothermia and hypoxia). Evidence for a reduction in the number of cases of post-partum haemorrhage, case fatality rates, stillbirths and institutional maternal mortality is
less strong. Short competency-based training in EmOC results in significant improvements in healthcare provider knowledge/skills and change in clinical practice. There is emerging evidence that this results in improved health outcomes.

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More Information

Uncontrolled Keywords: Emergency obstetric care, newborn care, training, evaluation, effectiveness, health outcomes, systematic review
Depositing User: Mselenge Mdegela

Identifiers

Item ID: 15972
Identification Number: https://doi.org/10.1093/heapol/czz028
ISSN: 1460-2237
URI: http://sure.sunderland.ac.uk/id/eprint/15972
Official URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC66615...

Users with ORCIDS

ORCID for Charles Ameh: ORCID iD orcid.org/0000-0002-2341-7605
ORCID for Mselenge Mdegela: ORCID iD orcid.org/0000-0002-0374-6583
ORCID for Sarah White: ORCID iD orcid.org/0000-0001-5535-8075
ORCID for Nynke van den Broek: ORCID iD orcid.org/0000-0001-8523-2684

Catalogue record

Date Deposited: 05 May 2023 15:00
Last Modified: 05 May 2023 15:00

Contributors

Author: Charles Ameh ORCID iD
Author: Mselenge Mdegela ORCID iD
Author: Sarah White ORCID iD
Author: Nynke van den Broek ORCID iD

University Divisions

Faculty of Health Sciences and Wellbeing > School of Psychology

Subjects

Sciences > Health Sciences

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