Data_Sheet_1_Helping Mothers Survive: Program Evaluation and Early Outcomes of Maternal Care Training in the Dominican Republic.PDF

Introduction: In 2017, approximately 295,000 women died during and immediately following pregnancy and childbirth worldwide, with 94% of these deaths occurring in low-resource settings. The Dominican Republic (DR) exhibits one of the highest maternal mortality ratios in the region of Latin America and the Caribbean despite the fact that 99% of registered births in the country are reportedly attended by a skilled birth attendant. This paradox implies that programs to support healthcare worker knowledge and skills improvement are vital to improving maternal health outcomes in the DR. Helping Mothers Survive (HMS) is a provider training program developed by Jhpiego and global partners. The goal of HMS is to combat maternal mortality by contributing to quality improvement efforts that reinforce maternal health skills of local healthcare workers.Methods: An international, multisectoral group of stakeholders collaborated in the implementation of two HMS curricula, Bleeding After Birth (BAB) and pre-eclampsia & eclampsia (PE&E). Demographic information as well as pre- and post-training knowledge scores were recorded for each participant. Knowledge score improvement was assessed in order to support effectiveness of the program on knowledge acquisition of healthcare workers.Results: Three hundred and twenty healthcare workers participated in the HMS training workshops between October 2016–August 2020. Of the 320 participants, 132 were trained as master trainers. The majority of participants identified as attending physicians, followed by residents/interns, nurses, students, and “other.” A significant improvement in knowledge scores was observed for both the BAB and PE&E curricula, with a 21.24 and 30.25% change in average score (pre- to post-test), respectively. In response to COVID-19 pandemic restrictions, flexibility of the local team led to a PE&E virtual training pilot workshop in August 2020.Discussion/Conclusions: Simulation-based training improved the knowledge levels of healthcare workers for both HMS curricula. These results suggest that simulation-based workshops have an impact on knowledge acquisition and skills of healthcare workers immediately following training. For the PE&E curriculum, no significant difference in knowledge acquisition was observed between in-person and virtual training sessions. The ongoing pandemic poses challenges to program implementation; however, these preliminary results provide evidence that conducting virtual workshops may be a viable alternative to in-person training.

引言：2017年，全球约有295,000名妇女在怀孕期间及分娩后不久去世，其中94%的死亡发生在资源匮乏的环境中。尽管多米尼加共和国（简称DR）99%的注册分娩均有专业助产士在场，但该地区拉丁美洲及加勒比海地区却呈现出最高的孕产妇死亡率之一。这一悖论表明，支持医疗工作者知识及技能提升的项目对于改善DR的孕产妇健康结果至关重要。‘帮助母亲生存’（简称HMS）是由Jhpiego及其全球合作伙伴开发的一项提供者培训项目。HMS的目标是通过加强当地医疗工作者孕产妇健康技能的质量改进努力，来对抗孕产妇死亡率。方法：一个由国际多部门利益相关者组成的团队共同实施了HMS的两个课程，即‘分娩后出血’（简称BAB）和‘妊娠高血压’及‘子痫’（简称PE&E）。为每位参与者记录了人口统计信息以及培训前后的知识得分。评估知识得分的提升，以支持该计划在医疗工作者知识获取方面的有效性。结果：在2016年10月至2020年8月期间，320名医疗工作者参与了HMS培训研讨会。在320名参与者中，132人被培训为高级培训师。大部分参与者为出席医师，其次是住院医师/实习医师、护士、学生以及其他人员。BAB和PE&E课程的知识得分均观察到显著提升，平均得分（从培训前到培训后）分别提高了21.24%和30.25%。鉴于COVID-19大流行期间的限制，当地团队的灵活性导致在2020年8月进行了一次PE&E虚拟培训试点研讨会。讨论/结论：基于模拟的培训提高了医疗工作者对HMS两个课程的知识水平。这些结果表明，基于模拟的工作坊对培训后医疗工作者知识获取和技能有显著影响。对于PE&E课程，个人培训和虚拟培训在知识获取方面没有观察到显著差异。持续的疫情给项目实施带来了挑战；然而，这些初步结果提供了证据，表明进行虚拟研讨会可能是在场培训的可行替代方案。