Ashley Rosenberg1, Kenneth Williams2, Jeanne D'Arc Nyinawankusi3, Basil Asay4, Luke Wolfe1, David Ntirushwa5, Emmanuel Ndikuryayo5, Amanda Ritter6, Jean Marie Uwitonze3, Ignace Kabagema3, Theophile Dushime3, Sudha Jayaraman1. 1. Division of Acute Care Surgery, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. 2. Center for Trauma and Critical Care Education, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA. 3. Service d'Aide Medicale Urgente, Rwanda Ministry of Health, Kigali, Rwanda. 4. HCA Healthcare, Richmond, VA, USA. 5. Department of Obstetrics and Gynecology, University Teaching Hospital of Kigali, Kigali, Rwanda. 6. Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Abstract
OBJECTIVE: To improve maternal mortality rates, our collaboration developed and implemented a context-specific, prehospital Emergency Obstetrics and Neonatal Course (EONC) and train-the-trainers program in Rwanda. METHODS: Two cohorts of staff participated in the program-the SAMU emergency medical service and staff from district hospitals. A 2-day course was developed, consisting of skills stations, simulations, and didactics. A 50-question assessment was administered to both cohorts before and after the courses. Student's t test and matched paired t tests were used to evaluate the assessments through retrospective analysis of the data. RESULTS: EONC1 median scores were 60% versus 92% (pre vs post), using matched-pair analysis of 20 participants. EONC2 median scores were 52% versus 96% (pre vs post), using matched-pair analysis of participants. A one-way analysis of variance mean square analysis showed that regardless of the baseline level of training for each participant, all trainees reached similar post-course assessment scores (F(1) = 8.35, P = 0.0059). CONCLUSION: Optimal prehospital management of obstetric emergencies is essential to prevent needless mortality and morbidity. This study demonstrated that a context-appropriate prehospital obstetric and neonatal training program could be effectively developed and implemented for the SAMU team in Kigali, Rwanda.
OBJECTIVE: To improve maternal mortality rates, our collaboration developed and implemented a context-specific, prehospital Emergency Obstetrics and Neonatal Course (EONC) and train-the-trainers program in Rwanda. METHODS: Two cohorts of staff participated in the program-the SAMU emergency medical service and staff from district hospitals. A 2-day course was developed, consisting of skills stations, simulations, and didactics. A 50-question assessment was administered to both cohorts before and after the courses. Student's t test and matched paired t tests were used to evaluate the assessments through retrospective analysis of the data. RESULTS: EONC1 median scores were 60% versus 92% (pre vs post), using matched-pair analysis of 20 participants. EONC2 median scores were 52% versus 96% (pre vs post), using matched-pair analysis of participants. A one-way analysis of variance mean square analysis showed that regardless of the baseline level of training for each participant, all trainees reached similar post-course assessment scores (F(1) = 8.35, P = 0.0059). CONCLUSION: Optimal prehospital management of obstetric emergencies is essential to prevent needless mortality and morbidity. This study demonstrated that a context-appropriate prehospital obstetric and neonatal training program could be effectively developed and implemented for the SAMU team in Kigali, Rwanda.
Authors: Sudha Jayaraman; Faustin Ntirenganya; Menelas Nkeshimana; Ashley Rosenberg; Theophile Dushime; Ignace Kabagema; Jean Marie Uwitonze; Eric Uwitonize; Jeanne d'Arc Nyinawankusi; Robert Riviello; Irene Bagahirwa; Kenneth L Williams; Elizabeth Krebs; Rebecca Maine; Paulin Banguti; Stephen Rulisa; Patrick Kyamanywa; Jean Claude Byiringiro Journal: Ann Glob Health Date: 2021-10-26 Impact factor: 2.462