Assessment of facility and health worker readiness to provide quality antenatal, intrapartum and postpartum care in rural Southern Nepal.
Tsering P Lama, Melinda K Munos, Joanne Katz...
https://pubmed.ncbi.nlm.nih.gov/31906938Actively Recruiting
Phase Not Applicable
FEMALE
Healthy Volunteers
ID06577922
Evaluation of Maternal & Newborn Health Simulation Lab Centers of Excellence in Seven Referral Hospitals of Nepal
Led by One Heart Worldwide · Updated on 2024-09-03
1464
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
Postpartum hemorrhage and birth asphyxia are leading causes of death for mothers and newborns worldwide, especially in low and middle-income countries. While Nepal has improved maternal and neonatal health, gaps remain in healthcare providers' knowledge and skills, likely due to limited practical experience. This study evaluates the implementation and effectiveness of simulation-based training centers in seven referral hospitals in Nepal to improve care for labor, bleeding after birth, and newborn resuscitation using a RE-AIM framework and a quasi-experimental pre- and post-test design. The project establishes high-fidelity simulation labs with multiple rooms and equipment in each hospital, providing training focused on Essential Care for Labor and Birth, Bleeding after Birth, and Helping Babies Breathe modules. Training is given to maternal and newborn health staff, including trainers and simulation lab operators. The intervention group receives this training after an initial pre-test phase. Data collection on maternal and neonatal health outcomes continues throughout pre-test, intervention, and post-test phases. Participants include women delivering vaginally, their newborns, and healthcare providers in the selected hospitals. Data collected include postpartum hemorrhage incidence, neonatal APGAR scores at 5 minutes, and blood transfusion rates after hemorrhage. Skills and team performance of providers are assessed before and six months after training. Qualitative interviews and focus groups explore challenges and implementation status. The study uses daily data collection and statistical analyses, with a total participation duration of about 15 months for outcome monitoring and six months for skill assessment.
CONDITIONS
Brief Title
Evaluation of Maternal & Newborn Health Simulation Lab Centers of Excellence in Nepal
Who Can Participate
FEMALE
Healthy Volunteers
Eligibility Criteria
You may qualify if you...
- Women who have recently delivered vaginally in the study hospital
- Newborns delivered at the study hospital with gestational age 37 weeks or more and birth weight 2500 grams or more
- Maternal and Newborn Health staff working in selected hospitals for at least 3 months
You will not qualify if you...
- Women with postpartum hemorrhage referred from other hospitals
- Babies born outside the study hospital
- Newborns with congenital abnormalities
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
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3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
Participants include women who have recently delivered vaginally, newborns delivered at the hospital with gestational age of 37 weeks or more and birth weight of 2500 grams or more, and maternal and newborn health staff working in selected hospitals for at least 3 months.
Establishment of Simulation Lab and Training
Duration - Initial setup and training phase (duration not explicitly stated)
Participants involved in the trial will experience the establishment of maternal and neonatal health simulation labs in each hospital, including equipment installation and training of health care providers on simulation-based methods focusing on essential maternal and newborn care skills.
Training sessions and simulation lab operation trainings provided to hospital staff; specific visit schedule not provided.
Effectiveness Assessment
Duration - 6 months after completion of intervention
Participants undergo skill assessments and team performance evaluations before and 6 months after the intervention to measure changes in competence and team communication in managing maternal and newborn health emergencies.
Multiple assessments including Objective Structured Clinical Examinations and team performance evaluations conducted by trained simulation experts.
Maternal and Neonatal Outcomes Data Collection
Duration - 6 months pre-intervention and 6 months post-intervention (total 12 months)
Participants' maternal and neonatal health outcomes, such as incidence of postpartum hemorrhage, blood transfusion rates, and newborn APGAR scores, are monitored and recorded during the 6 months before and after the intervention to assess the impact of the simulation labs.
Continuous data collection from hospital records and patient charts during delivery and postpartum periods.
Qualitative Assessments and Maintenance
Duration - Throughout the study period
Participants involved in interviews and focus groups share their experiences, challenges, and recommendations regarding the simulation labs; hospital actions for sustaining simulation-based training are also observed.
In-depth interviews and focus group discussions conducted at various times; specific visit schedule not provided.
Trial Site Locations
Total: 1 location
1
Paropakar Maternity and Women's Hospital, Koshi Hospital, Narayani Hospital, Province Hospital Surkhet, BPKIHS, Pokhara Academy of health sciences, and Madhesh Institute of Health Sciences
Kathmandu, Bagmati, Nepal, 44700
Actively Recruiting
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Research Team
N
Nashna Maharjan, MHPE
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
SEQUENTIAL
Primary Purpose
HEALTH_SERVICES_RESEARCH
Number of Arms
2
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Ruma Rajbhandari, Shovana Rai, Sejal Hathi...
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D Acharya, R Paudel
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Emmanuel Ugwa, Emmanuel Otolorin, Mark Kabue...
https://pubmed.ncbi.nlm.nih.gov/30103761