Hulsbergen Myrrith, Abera Birhanu, Adefris Mulat, Kassahun Dawit, Meulenbeld Marieke, van Nievelt Sabine, Ameh Charles, Bruinooge Mimosa, Rijken Marcus J, Stekelenburg Jelle
Working Party on International Safe Motherhood and Reproductive Health, Groningen, Netherlands.
Center for Evidence Based Education, Amsterdam University Medical Center, Amsterdam, The Netherlands.
PLOS Glob Public Health. 2023 Sep 26;3(9):e0000889. doi: 10.1371/journal.pgph.0000889. eCollection 2023.
In Ethiopia maternal and perinatal morbidity and mortality remains high. Timely access to quality emergency obstetric and neonatal care is essential for the prevention of adverse outcomes. Training healthcare providers can play an important role in improving quality of care, thereby reducing maternal and perinatal mortality and morbidity. The aim of this study was to evaluate change of knowledge, skills and behaviour in health workers who attended a postgraduate Emergency Obstetric and Newborn Care training in Gondar, Ethiopia. A descriptive study with before-after approach, using a mix of quantitative and qualitative data, based on Kirkpatrick's model for training evaluation was conducted. The evaluation focussed on reaction, knowledge, skills, and change in behaviour in clinical practice of health care providers and facilitator's perspectives on performance. A 'lessons learned approach' was included to summarize facilitators' perspectives. Health care providers reacted positively to the Emergency Obstetric and Newborn Care training with significant improvement in knowledge and skills. Of the 56 participants who attended the training, 44 (79%) were midwives. The main evaluation score for lectures was 4,51 (SD 0,19) and for breakout sessions was 4,52 (SD 0.18) on scale of 1-5. There was a statistically significant difference in the pre and post knowledge (n = 28, mean difference 13.8%, SD 13.5, t = 6.216, p<0.001) and skills assessments (n = 23, mean difference 27.4%, SD 22.1%, t = 5.941, p<0.001). The results were the same for every component of the skills and knowledge assessment. Overall, they felt more confident in performing skills after being trained. Local sustainability, participant commitment and local context were identified as challenging factors after introducing a new training program. In Gondar Ethiopia, the Emergency Obstetric and Newborn Care training has the potential to increase skilled attendance at birth and improve quality of care, both vital to the reduction of maternal and perinatal mortality and morbidity.
在埃塞俄比亚，孕产妇和围产期发病率及死亡率仍然很高。及时获得高质量的紧急产科和新生儿护理对于预防不良后果至关重要。培训医疗保健提供者在提高护理质量方面可发挥重要作用，从而降低孕产妇和围产期死亡率及发病率。本研究的目的是评估在埃塞俄比亚贡德尔参加研究生紧急产科和新生儿护理培训的卫生工作者在知识、技能和行为方面的变化。采用基于柯克帕特里克培训评估模型的前后对比描述性研究，结合定量和定性数据。评估重点在于医疗保健提供者的反应、知识、技能以及临床实践中的行为变化，还有促进者对表现的看法。纳入了“经验教训方法”以总结促进者的观点。医疗保健提供者对紧急产科和新生儿护理培训反应积极，知识和技能有显著提高。参加培训的56名参与者中，44名（79%）是助产士。讲座的主要评估得分在1 - 5分制中为4.51（标准差0.19），分组讨论的得分为4.52（标准差0.18）。知识评估前后（n = 28，平均差异13.8%，标准差13.5，t = 6.216，p<0.001）和技能评估前后（n = 23，平均差异27.4%，标准差22.1%，t = 5.941，p<0.001）存在统计学显著差异。技能和知识评估的每个组成部分结果相同。总体而言，他们在接受培训后对执行技能更有信心。引入新培训计划后，当地可持续性、参与者的投入和当地情况被确定为具有挑战性的因素。在埃塞俄比亚贡德尔，紧急产科和新生儿护理培训有可能增加熟练接生率并提高护理质量，这两者对于降低孕产妇和围产期死亡率及发病率都至关重要。
