Prehospital emergency obstetric and neonatal care train-the-trainers program in Rwanda

Int J Gynaecol Obstet. 2021 Jun;153(3):503-507. doi: 10.1002/ijgo.13491. Epub 2020 Dec 29.

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.

Keywords: Education; Obstetrics; Prehospital; Rwanda.

MeSH terms

  • Adult
  • Curriculum
  • Educational Measurement
  • Emergencies
  • Emergency Medical Services*
  • Female
  • Hospitals, District
  • Humans
  • Infant, Newborn
  • Inservice Training*
  • Medical Staff, Hospital* / education
  • Neonatology* / education
  • Nursing Staff, Hospital* / education
  • Obstetrics* / education
  • Pregnancy
  • Retrospective Studies
  • Rwanda