Bucyebucye Jean Pierre, Gatsinzi Bagambe Patrick, Ntasumbumuyange Diomede, Kaberuka Gerard, Igiraneza Zubeda, Ishimwe Bazakare Marie Laetitia, Ugiruwatuma Thomas, Igiraneza Alice, Ntakirutimana Charlotte, Habimana Samson
College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Kigali University Teaching Hospital, Kigali, Rwanda.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251320706. doi: 10.1177/17455057251320706. Epub 2025 May 8.
Complications of unsafe abortion are public health issue and account for 13% of maternal mortalities globally. Maternal mortality in Rwanda remains high at 203/100,000 live births. Prevalence of unintended pregnancy in Rwanda is estimated at 12%, abortion-related complications are estimated at 10.7 per 1000 and abortion-related maternal mortality remains high (8%). Existing literature suggests that many clinicians face challenges in delivering reproductive health services, including abortion and postabortion care. These challenges often caused by a lack of confidence and insufficient training.
This study aimed to assess the effect of training medical doctors on their knowledge of abortion and postabortion care in Rwanda.
A quasi-experimental design was used.
We trained clinicians from six hospitals in Rwanda on abortion and postabortion care using updated national guidelines and the WHO Safe Abortion Care Guideline. Clinicians were trained in 3-h-long sessions over 3 months including lecture and self-learning using shared guidelines books during this period. Pretest and posttest were implemented. In total, four training sessions were held. Training was theoretical only. We compared pretest and posttest scores using paired -test; value <0.05 was considered statistically significant.
Thirty medical doctors from district and referral hospitals were trained. There was an increase in marks between pretest and posttest. This increase was statistically significant among trainees from three district hospitals with values 0.046, <0.001, and <0.001, respectively. This increase was statistically significant among both gender groups of participants with value of 0.005 and 0.001 for male and female trainees, respectively. There was no statistically increase in marks for trainees in teaching hospitals ( value = 0.168).
We found a statistical increase in marks comparing pre- and posttest scores for clinicians attending district hospitals. This increase was observed in both male and female trainees. This increase in marks suggests that the training had a positive impact on clinicians' knowledge that impacted their decision making and elaboration of management plan for abortion and postabortion care provision.
不安全堕胎的并发症是一个公共卫生问题，在全球孕产妇死亡中占13%。卢旺达的孕产妇死亡率仍然很高，每10万例活产中有203例死亡。卢旺达意外怀孕的患病率估计为12%，与堕胎相关的并发症估计为每1000例中有10.7例，与堕胎相关的孕产妇死亡率仍然很高（8%）。现有文献表明，许多临床医生在提供生殖健康服务方面面临挑战，包括堕胎和堕胎后护理。这些挑战往往是由于缺乏信心和培训不足造成的。
本研究旨在评估培训医生对其在卢旺达堕胎和堕胎后护理知识方面的影响。
采用准实验设计。
我们使用更新后的国家指南和世界卫生组织安全堕胎护理指南，对卢旺达六家医院的临床医生进行堕胎和堕胎后护理培训。临床医生在3个月内参加了为期3小时的培训课程，包括讲座和在此期间使用共享指南书籍进行自学。进行了预测试和后测试。总共举办了四次培训课程。培训仅为理论培训。我们使用配对t检验比较预测试和后测试分数；P值<0.05被认为具有统计学意义。
来自地区医院和转诊医院的30名医生接受了培训。预测试和后测试之间的分数有所增加。在三家地区医院的受训者中，这种增加具有统计学意义，P值分别为0.046、<0.001和<0.001。在男女两组参与者中，这种增加也具有统计学意义，男性和女性受训者的P值分别为0.005和0.001。教学医院的受训者分数没有统计学上的增加（P值=0.168）。
我们发现，比较地区医院临床医生的预测试和后测试分数，分数有统计学上的增加。在男性和女性受训者中均观察到这种增加。分数的增加表明培训对临床医生的知识产生了积极影响，这影响了他们在堕胎和堕胎后护理提供方面的决策和管理计划的制定。
