Stubbe Lea, Philippeit Anja, Philippeit Jill, Kaukemüller Laura, Kruppa Markus, Sunder-Plassmann Marie, Ruppert Alicia, Hillemanns Peter, Mugisha Jerome, Klapdor Rüdiger
Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany.
Department of Gynecology, KRH Clinic Siloah, Hannover, Germany.
Womens Health Rep (New Rochelle). 2024 Oct 7;5(1):775-784. doi: 10.1089/whr.2024.0068. eCollection 2024.
High maternal and newborn mortality rates in Sub-Saharan Africa indicate the need for global action interventions. Thus, the clinic cooperation midwife exchange with Uganda (MEWU) between Hannover Medical School and Mutolere Hospital, Uganda, was founded. This study, as the first intervention within the MEWU framework, explored whether a web-based approach is suitable for developing, training, and establishing standard operating procedures (SOPs) at Mutolere Hospital. We focused on assessing midwives' confidence in midwifery core competencies.
The study was conducted in a prospective, non-controlled intervention design. As a quality improvement tool, the Plan, Do, Check, Act cycle was implemented. SOPs for standard obstetric care were developed and trained in online meetings. Qualitative and quantitative data were collected through a questionnaire completed pre- and post-intervention by participating midwives, evaluations, minutes and video recordings of each case training, and annual analytical reports from Mutolere Hospital containing morbidity and mortality data.
The online intervention was successfully implemented. Nine SOPs on basic obstetric care were developed, trained in online case training, and integrated into clinical practice at Mutolere Hospital. An increase in midwives' confidence regarding all surveyed core competencies was observed. There were no significant changes in the hospital's morbidity and mortality rates. The quality management system was implemented to optimize the follow-up projects further.
This pilot study shows the potential of web-based interventions as a quality improvement tool in developing countries. The developed SOPs and video database are being used in subsequent studies and extended to further health centers in the Kisoro region.
撒哈拉以南非洲地区孕产妇和新生儿死亡率居高不下，这表明需要采取全球行动干预措施。因此，汉诺威医学院与乌干达穆托莱雷医院之间建立了乌干达临床合作助产士交流项目（MEWU）。本研究作为MEWU框架内的首次干预措施，探讨了基于网络的方法是否适合在穆托莱雷医院制定、培训和建立标准操作程序（SOP）。我们重点评估了助产士对助产核心能力的信心。
本研究采用前瞻性非对照干预设计。作为一种质量改进工具，实施了计划、执行、检查、行动循环。在在线会议上制定并培训了标准产科护理的SOP。通过参与研究的助产士在干预前后填写的问卷、每次病例培训的评估、会议记录和视频记录，以及穆托莱雷医院包含发病率和死亡率数据的年度分析报告，收集定性和定量数据。
在线干预成功实施。制定了9项基本产科护理的SOP，在在线病例培训中进行了培训，并纳入了穆托莱雷医院的临床实践。观察到助产士对所有调查的核心能力的信心有所增强。医院的发病率和死亡率没有显著变化。实施了质量管理系统以进一步优化后续项目。
这项试点研究表明，基于网络的干预措施在发展中国家作为质量改进工具具有潜力。所制定的SOP和视频数据库正在后续研究中使用，并扩展到基索罗地区的其他健康中心。
