Smith H, Lugina H, Mlay R
Effective Health Care Alliance Programme, International Health Research Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
East Afr Med J. 2004 Nov;81(11):603-8.
To evaluate the impact of an educational intervention to introduce the principles of evidence based obstetric care and encourage mobility during labour in government hospitals in Dar es Salaam.
An observational study.
Four government hospitals; two in Dar es Salaam and two in coastal region of Tanzania.
Following implementation of the workshops, practice changed significantly for mobility during labour at the district and regional hospitals; midwives at these hospitals appeared to be aware of the benefits and were willing to encourage women to be mobile during labour. Practice changed little at the referral hospital. Most women delivering at the referral hospital had been transferred from regional or district hospitals with complications.
This small study demonstrates the potential of using educational workshops to change childbirth practice at the district and regional level in Tanzania. Institutionalisation of practice changes involves influencing policy-makers, engaging opinion leaders to disseminate evidence and advocacy for change among their peers, as well as developing mechanisms to overcome barriers to practice change at the hospital level. Results from this study will feed in to a project to develop evidence-based guidelines for childbirth care, involving policy makers, practitioners and hospital managers.
评估在达累斯萨拉姆的政府医院开展一项教育干预措施的影响，该措施旨在引入循证产科护理原则并鼓励分娩期间的活动。
一项观察性研究。
四家政府医院；两家位于达累斯萨拉姆，两家位于坦桑尼亚沿海地区。
在举办研讨会之后，地区和区域医院分娩期间活动的做法发生了显著变化；这些医院的助产士似乎意识到了活动的益处，并愿意鼓励产妇在分娩期间活动。转诊医院的做法变化不大。在转诊医院分娩的大多数妇女是因并发症从地区或区域医院转来的。
这项小型研究表明了利用教育研讨会改变坦桑尼亚地区和区域层面分娩做法的潜力。做法改变的制度化涉及影响政策制定者、促使意见领袖传播证据并在同行中倡导变革，以及建立机制以克服医院层面做法改变的障碍。本研究结果将为一个制定分娩护理循证指南的项目提供参考，该项目涉及政策制定者、从业者和医院管理人员。
