In-service training in emergency obstetric and early newborn care Pregnancy and Childbirth
Conditions
Interventions
Two types of training approaches to be used to build capacity of healthcare providers in maternity services to provide emergency obstetric and early newborn care in twelve districts in the Republic of
training of trainers to deliver EOST to be done at the start of the trial in all sites (and subsequently rolled out repeatedly to staff over the duration of the trial)
ESMOE training delivered at different time points in the twelve districts based on the randomisation of districts (in line with stepped wedge design). All facilities within a district are to be traine
Sponsors
Liverpool School of Tropical Medicine
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Note: Assessment of intervention done at healthcare facility level 1. Districts for the intervention were identified by the National Department of Heath because of poor health outcomes measured by institutional maternal mortality ration and district level stillbirth rate (within RSA). This is an externally-driven selection and is not representative of all regions in the Republic of South Africa. The final number of eligible districts is 12 2. Within the identified districts, all healthcare facilities designated to provide emergency obstetric and newborn care services as basic (BEmOC) and comprehensive (CEmOC) level in the districts to be included in the study (staff invited for training). The total number of such facilities identified is 136 3. Ultimate inclusion in the study based on ability to provide necessary data for monitoring the results of the intervention. The total number of such facilities is 133. (Other facilities meeting the first two criteria are eligible for inclusion in the training but not the measurement of effectiveness)
Exclusion criteria
Exclusion criteria: 1. Facilities in non-selected districts 2. Facilities not designated to provide emergency obstetric and newborn care services as basic (BEmOC) or comprehensive (CEmOC) level 3. Facilities unable to provide data for assessing results of the intervention (this is only a criterion for inclusion in the facility-based assessment and does not exclude staff in those facilities being included in training)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| All outcomes are to be measured monthly in each facility (according to the stepped wedge design) over the study period (26 months): 1. Facility-level stillbirth rate (number of stillbirths per 1000 births) 2. Facility-level maternal case fatality rate for direct obstetric complications (number of maternal deaths due to direct obstetric complications per 100 cases of direct emergency obstetric complications) 3. Facility-level early newborn death rate (number of early newborn deaths per 1000 live births) 4. Facility-level maternal mortality ratio (number of maternal deaths per 100,000 live births) | — |
Secondary
| Measure | Time frame |
|---|---|
| Number of women seeking care in healthcare facilities measured in each facility each month (according to the stepped wedge design) over the course of the study period (26 months) | — |
Countries
South Africa
Outcome results
None listed