New Avenues to Increase the Use of Skilled Birth Attendants in Ghana

描述（由申请人提供）：本提案的长期职业目标是申请人成为一名独立研究人员，并在设计和实施与撒哈拉以南非洲人口和孕产妇和新生儿卫生政策相关的研究方面获得培训。近期目标是完成拟议的培训方案，其中包括以下目标：1)掌握先进的定性和定量方法的研究技能，以便在撒哈拉以南非洲进行调查、焦点小组和参与者观察研究；2)将研究成果转化为撒哈拉以南非洲地区的临床实践方案；3)在撒哈拉以南非洲建立关系，以影响孕产妇-新生儿保健政策；4)获得一个独立的终身教职。职业规划的重点是加纳大学（UG）、密歇根大学（UM）和北卡罗来纳大学（UNC）的课程，并参加研讨会和科学会议。教师导师，博士。Tim Johnson （UM）和Richard Adanu （UG）是加纳妇女生殖健康领域的主要专家，他们将参与执行研究和培训计划的各个方面。该研究项目将为开展基于社区的研究提供经验，在资源匮乏的诊所环境中进行可行性研究，并使用准实验设计来检查项目的有效性。研究项目从阿尚蒂地区的一家加纳地区医院抽取样本，研究的总体目标是：1)修改家庭救生技能（HBLSS）计划，供加纳临床环境中的熟练助产士使用（HBLSS- m）；2)确定HBLSS-M在加纳的可行性；3)确定接触HBLSS-M是否会增加加纳妇女对熟练助产士的使用并改善分娩结果。为了实现目标1，将采用焦点小组设计的社区参与策略来开发HBLSS-M，并获得所服务社区的支持。为了实现目标2，将培训5名熟练的助产士来提供HBLSS-M，并将评估其可行性。为了满足目标3，将采用两组比较设计（每组92名参与者）来确定由10名助产士接生的HBLSS- M是否能在专业助产士接生的情况下产生更多的分娩数量，并改善分娩结果。据推测，接受HBLSS-M计划的育龄妇女比对照组的育龄妇女更有可能由熟练的助产士分娩，并体验到更好的分娩结果。作为世界上最重要的研究机构之一，澳大为护理研究提供了非常丰富的环境。拟议的研究培训计划与校长办公室牵头的澳大国际倡议一致。20多年来，澳门大学一直寻求与加纳的合作伙伴相互接触。加纳大学是加纳七所公立大学中历史最悠久、规模最大的大学。它是西非迄今为止最负盛名的大学。它成立于1948年，是黄金海岸大学学院，最初是伦敦大学的附属学院，负责监督其学术课程并授予学位。它于1961年获得大学资格，现在有近30,000名学生。在完成拟议的五年培训计划后，申请人将有能力进行跨学科、高影响力的研究，以传达撒哈拉以南非洲专业助产士的作用。

DESCRIPTION (provided by applicant): The long term career goal of this proposal is for the applicant to become an independent researcher and to gain training in designing and implementing studies that are relevant to populations and maternal and newborn health policy in sub-Saharan Africa. The immediate goal is to complete the proposed training program that includes the following objectives: 1) to acquire research skills in advanced qualitative and quantitative methods in order to conduct surveys, focus groups, and participant-observation studies in sub-Saharan Africa; 2) to translate research findings into clinical practice protocols in sub-Saharan Africa; 3) to establish relationships in sub-Saharan Africa in order to influence maternal-newborn health policy; and 4) to secure an independent tenure-track faculty position. Key Elements of Career Plan The career plan focuses on coursework at the University of Ghana (UG), University of Michigan (UM) and the University of North Carolina (UNC) with participation and presentations at seminars and scientific meetings. The faculty mentors, Drs. Tim Johnson (UM) and Richard Adanu (UG), leading experts in the field of Ghanaian women's reproductive health, will be involved in all aspects of carrying out the research and training plan. The research project will allow for experiences in conducting community based research, feasibility studies in low resource clinic settings, and the use of quasi-experimental design in examining program effectiveness. Research Project Drawing on a sample from one Ghanaian District Hospital in the Ashanti Region, the overall aims of the research are to: 1) modify the Home-Based Life Saving Skills (HBLSS) program for use by skilled midwives (HBLSS-M) in a Ghanaian clinical setting; 2) establish the feasibility of the HBLSS-M in Ghana; and 3) determine whether exposure to the HBLSS-M increases Ghanaian women's use of skilled birth attendants for delivery and improves birth outcomes. To meet Aim 1, a community participation strategy with a focus group design will be used to develop the HBLSS-M and to get buy-in from the community being served. To meet Aim 2, five skilled midwives will be trained to deliver the HBLSS-M and feasibility will be assessed. To meet Aim 3, a two-group comparison design (92 participants in each group) will be used to determine whether the HBLSS- M, delivered by 10 midwives produces a greater number of deliveries with professional midwives and improves birth outcomes. It is hypothesized that child-bearing women who receive the HBLSS-M program will be more likely to deliver with skilled midwives and experience improved birth outcomes than the child-bearing women in the comparison group. Environment As one of the world's foremost research institutions, the UM provides an exceptionally rich environment for nursing research. The proposed research training plan is congruent with the UM international initiatives spearheaded from the President's Office. For more than 20 years, the UM has sought mutual engagement with our partners from Ghana. The UG is the oldest and largest of the seven Ghanaian public universities. It is by far the most prestigious university in West Africa. It was founded in 1948 as the University College of the Gold Coast and was originally an affiliate college of the University of London, which supervised its academic programs and awarded degrees. It gained full university status in 1961, and now has nearly 30,000 students. After completion of the proposed five-year training program, the applicant will be well positioned to conduct interdisciplinary, high-impact research that conveys the role of professional midwives in sub-Saharan Africa. PUBLIC HEALTH RELEVANCE: This career development plan provides coursework and mentored experiences to acquire additional skills for an independent global health research career. The research project develops a modified version of the Home-Based Life Saving Skills (HBLSS-M), tests its feasibility in a Ghanaian setting and examines whether exposure to the HBLSS-M increases Ghanaian women's use of skilled birth attendants for delivery and improves birth outcomes.