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Knowledge and Skills of Healthcare Providers in Sub-Saharan Africa and Asia before and after Competency-Based Training in Emergency Obstetric and Early Newborn Care

Ameh, Charles, Kerr, Robert, Madaj, Barabara, Mdegela, Mselenge, Kana, Terry, Jones, Susan, Lambert, Jaki, Dickinson, Fiona, White, Sarah and van den Broek, Nynke (2016) Knowledge and Skills of Healthcare Providers in Sub-Saharan Africa and Asia before and after Competency-Based Training in Emergency Obstetric and Early Newborn Care. PLOS ONE, 11 (12). e0167270-e0167270. ISSN 1932-6203

Item Type: Article

Abstract

Background
Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this.
Methods
We evaluated knowledge and skills among 5,939 healthcare providers before and after 3±5 days `skills and drills' training in emergency obstetric and newborn care (EmOC&NC) conducted in 7 sub-Saharan Africa countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Zimbabwe) and 2 Asian countries (Bangladesh, Pakistan). Standardised assessments using multiple choice questions and objective structured clinical examination (OSCE) were used to measure change in knowledge and skills and the Improvement Ratio (IR) by cadre and by country. Linear regression was performed to identify variables associated with pre-training score and IR.
Results
99.7% of healthcare providers improved their overall score with a median (IQR) increase of 10.0% (5.0% - 15.0%) for knowledge and 28.8% (23.1% - 35.1%) for skill. There were significant improvements in knowledge and skills for each cadre of healthcare provider and for each country (p<0.05). The mean IR was 56% for doctors, 50% for mid-level staff and nurse-midwives and 38% for nursing-aides. A teaching job, previous in-service training, and higher percentage of work-time spent providing maternity care were each associated with a higher pre-training score. Those with more than 11 years of experience in obstetrics had the lowest scores prior to training, with mean IRs 1.4% lower than for those with no more than 2 years of experience. The largest IR was for recognition and management of obstetric haemorrhage (49±70%) and the smallest for recognition and management of obstructed labour and use of the partograph (6±15%).
Conclusions
Short in-service EmOC&NC training was associated with improved knowledge and skills for all cadres of healthcare providers working in maternity wards in both sub-Saharan Africa and Asia. Additional support and training is needed for use of the partograph as a tool to monitor progress in labour. Further research is needed to assess if this is translated into improved service delivery.

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More Information

Depositing User: Mselenge Mdegela

Identifiers

Item ID: 15974
Identification Number: https://doi.org/10.1371/journal.pone.0167270
ISSN: 1932-6203
URI: http://sure.sunderland.ac.uk/id/eprint/15974

Users with ORCIDS

ORCID for Charles Ameh: ORCID iD orcid.org/0000-0002-2341-7605
ORCID for Barabara Madaj: ORCID iD orcid.org/0000-0002-4073-3191
ORCID for Mselenge Mdegela: ORCID iD orcid.org/0000-0002-0374-6583
ORCID for Terry Kana: ORCID iD orcid.org/0000-0002-1501-6860
ORCID for Jaki Lambert: ORCID iD orcid.org/0000-0002-2206-7332
ORCID for Fiona Dickinson: ORCID iD orcid.org/0000-0002-5298-9127
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 15:11
Last Modified: 11 May 2023 12:08

Contributors

Author: Charles Ameh ORCID iD
Author: Barabara Madaj ORCID iD
Author: Mselenge Mdegela ORCID iD
Author: Terry Kana ORCID iD
Author: Jaki Lambert ORCID iD
Author: Fiona Dickinson ORCID iD
Author: Sarah White ORCID iD
Author: Nynke van den Broek ORCID iD
Author: Robert Kerr
Author: Susan Jones

University Divisions

Faculty of Health Sciences and Wellbeing > School of Psychology

Subjects

Sciences > Health Sciences

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