Linked: Improving maternal & child health through specialty training in Zambia

相关链接：改善母性

• 批准号: 8731985
• 负责人: Yakub F Mulla
• 金额: $ 48.5万
• 依托单位: UNIVERSITY OF ZAMBIA
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-27 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8731985
• 关键词: Address; Adherence; Africa South of the Sahara; Alabama; Area; Attention; Award; Awareness; Caring; Cessation of life; Child; Childbirth; Clinical; Collaborations; Communities; Data; Decentralization; Development; Discipline of obstetrics; Effectiveness; Emergency Situation; Ensure; Europe; Faculty; Funding; Future; Goals; Guidelines; Gynecology; Head; Health; Health Priorities; Infant Mortality; Infectious Diseases Research; Institution; Instruction; International; Intervention; Leadership; Life; Link; Maternal and Child Health; Measures; Medical; Medical Education; Mentorship; Methods; Modeling; Morbidity - disease rate; Neonatal; Neonatology; Newborn Infant; North America; Nurse Midwives; Operations Research; Outcome; Outcomes Research; Patient Monitoring System; Patients; Pediatrics; Perinatal; Physicians; Population; Postpartum Period; Pregnancy; Principal Investigator; Program Evaluation; Province; Research Infrastructure; Resources; Risk; Role; SERPINI2 gene; Scientist; Secure; Services; Specialist; Structure; System; Training; United Nations; Universities; Woman; Women' s Health; Work; Zambia; base; clinical care; cost effectiveness; early childhood; fetal medicine; global health; improved; innovation; medical schools; medical specialties; meetings; mortality; neonatal resuscitation; novel strategies; patient safety; population based; programs; response; simulation; skills training; tertiary care

Despite modest reductions in mortality over the past decade, the burden of maternal and early childhood death in Zambia remains among the highest in the world. In this application, we seek to improve maternal and child outcomes in Lusaka Province by enhancing specialty training for obstetric and neonatal care at the University of Zambia School of Medicine. Referral services are critically needed for the timely treatment of complications and must be strengthened alongside community-based initiatives to improve maternal and child health. We describe our medical education initiative in the context of four specific aims. First, we will enhance training through novel approaches in medical education, including patient-encounter simulations, team-based skills training, emergency drills, and faculty engagement. Second, we will standardize and improve clinical care by implementing medical guidelines and ensuring their adherence through regular perinatal audits. Third, we will expand our medical education model to community-based nurse and midwife training, integrating our patient-encounter simulations into emergency obstetrical care, neonatal resuscitation, and essential newborn care. Finally, to assess the impact of these interventions, we will develop a framework for program evaluation and outcomes research, focusing on comprehensive surveillance of maternal and early childhood mortality. This emphasis on patient outcomes is a unique feature of our program and will provide value information to inform the cost-effectiveness and sustainability of our interventions. To accomplish these aims, we have assembled a strong team of clinician-educators and physician-scientists from three principal institutions: the University of Zambia, the Centre for Infectious Disease Research in Zambia, and the University of Alabama at Birmingham. By working within the administrative structure of UNZA's MEPI award, we substantially leverage these funds to address a well- established global health priority - making pregnancy and delivery safer - and to provide the framework for future health improvements across Zambia. RELEVANCE (See instructions): The risk of death during pregnancy and around delivery remains unacceptably high worldwide. While many have sought to expand access of services at the community level, such efforts must be accompanied by enhancements in facility-based care. This application seeks to improve the quality of clinical care and training at one tertiary care facility in Zambia and demonstrate its impact on population-level outcomes.

尽管过去十年来死亡率略有下降，但孕产妇和幼儿的负担仍然很重， 赞比亚的死亡率仍然是世界上最高的。在本申请中，我们寻求改善产妇 在卢萨卡省加强产科和新生儿护理专业培训， 赞比亚大学医学院。急需转诊服务，以便及时治疗 必须与基于社区的举措一起加强，以改善孕产妇和 儿童健康。我们在四个具体目标的背景下描述我们的医学教育计划。一是 通过医学教育中的新方法加强培训，包括患者接触模拟， 以团队为基础的技能培训，应急演习和教师参与。二是规范和 通过实施医疗指南并定期确保遵守这些指南来改善临床护理 围产期审计。第三，我们将把我们的医学教育模式扩大到社区护士和助产士 培训，将我们的患者遭遇模拟融入紧急产科护理，新生儿 复苏和基本新生儿护理。最后，为了评估这些干预措施的影响，我们将 制定方案评估和成果研究框架，重点是全面 监测产妇和幼儿死亡率。这种对患者结果的强调是一种独特的 我们的计划的特点，并将提供价值信息，以告知成本效益和可持续性 我们的干预措施。为了实现这些目标，我们组建了一支强大的临床教育团队， 来自三个主要机构的医生-科学家：赞比亚大学、传染病中心、 赞比亚疾病研究所和伯明翰的亚拉巴马大学。通过在 UNZA的MEPI奖的行政结构，我们充分利用这些资金来解决一个很好的- 建立全球卫生优先事项-使怀孕和分娩更安全-并提供框架， 未来赞比亚的健康状况将得到改善。 相关性（参见说明）： 在全世界，怀孕期间和分娩前后的死亡风险仍然高得令人无法接受。虽然许多 在努力扩大社区一级的服务范围的同时， 加强以设施为基础的护理。该申请旨在提高临床护理质量， 在赞比亚的一个三级保健设施进行培训，并展示其对人口一级结果的影响。

项目成果

Maternal and newborn outcomes at a tertiary care hospital in Lusaka, Zambia, 2008-2012.

赞比亚卢萨卡一家三级医院的孕产妇和新生儿结局，2008 年至 2012 年。

• DOI: 10.1002/ijgo.12036
• 发表时间: 2017-02
• 期刊: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
• 作者: Vwalika B;Stoner MC;Mwanahamuntu M;Liu KC;Kaunda E;Tshuma GG;Somwe SW;Ahmed Y;Stringer EM;Stringer JS;Chi BH
• 通讯作者: Chi BH