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dc.contributor.authorMcGready, R
dc.contributor.authorRijken, MJ
dc.contributor.authorTurner, C
dc.contributor.authorThan, HH
dc.contributor.authorTun, NW
dc.contributor.authorMin, AM
dc.contributor.authorHla, S
dc.contributor.authorWai, NS
dc.contributor.authorProux, K
dc.contributor.authorMin, TH
dc.contributor.authorGilder, ME
dc.contributor.authorSneddon, A
dc.date.accessioned2021-06-28T01:05:27Z
dc.date.available2021-06-28T01:05:27Z
dc.date.issued2021
dc.identifier.issn2398-502Xen_US
dc.identifier.doi10.12688/wellcomeopenres.16599.1en_US
dc.identifier.urihttp://hdl.handle.net/10072/405392
dc.description.abstractBackground: Short emergency obstetric care (EmOC) courses have demonstrated improved provider confidence, knowledge and skills but impact on indicators such as maternal mortality and stillbirth is less substantial. This manuscript evaluates Advanced Life Support in Obstetrics (ALSO) and Basic Life Support (BLSO) as an adult education tool, in a protracted, post-conflict and resource-limited setting. Methods: A mixed methods evaluation was used. Basic characteristics of ALSO and BLSO participants and their course results were summarized. Kirkpatrick's framework for assessment of education effectiveness included: qualitative data on participants' reactions to training (level 1); and quantitative health indicator data on change in the availability and quality of EmOC and in maternal and/or neonatal health outcomes (level 4), by evaluation of the post-partum haemorrhage (PPH) related maternal mortality ratio (MMR) and stillbirth rate in the eight years prior and following implementation of ALSO and BLSO. Results: 561 Thailand-Myanmar border health workers participated in ALSO (n=355) and BLSO (n=206) courses 2008-2020. Pass rates on skills exceeded 90% for both courses while 50% passed the written ALSO test. Perceived confidence significantly improved for all items assessed. In the eight-year block preceding the implementation of ALSO and BLSO (2000-07) the PPH related MMR per 100,000 live births was 57.0 (95%CI 30.06-108.3)(9/15797) compared to 25.4 (95%CI 11.6-55.4)(6/23620) eight years following (2009-16), p=0.109. After adjustment, PPH related maternal mortality was associated with birth before ALSO/BLSO implementation aOR 3.825 (95%CI 1.1233-11.870), migrant (not refugee) status aOR 3.814 (95%CI 1.241-11.718) and attending ≤four antenatal consultations aOR 3.648 (95%CI 1.189-11.191). Stillbirth rate per 1,000 total births was 18.2 (95%CI 16.2-20.4)(291/16016) before the courses, and 11.1 (95%CI 9.8-12.5)(264/23884) after, p=0.038. Birth before ALSO/ BLSO implementation was associated with stillbirth aoR 1.235 (95%CI 1.018-1.500). Conclusions: This evaluation suggests ALSO and BLSO are sustainable, beneficial, EmOC trainings for adult education in protracted, post-conflict, resource-limited settings.en_US
dc.description.peerreviewedYesen_US
dc.languageenen_US
dc.publisherF1000 Research Ltden_US
dc.relation.ispartofpagefrom94en_US
dc.relation.ispartofjournalWellcome Open Researchen_US
dc.relation.ispartofvolume6en_US
dc.subject.fieldofresearchMedical and Health Sciencesen_US
dc.subject.fieldofresearchClinical Sciencesen_US
dc.subject.fieldofresearchPublic Health and Health Servicesen_US
dc.subject.fieldofresearchcode11en_US
dc.subject.fieldofresearchcode1103en_US
dc.subject.fieldofresearchcode1117en_US
dc.titleA mixed methods evaluation of Advanced Life Support in Obstetrics (ALSO) and Basic Life Support in Obstetrics (BLSO) in a resource-limited setting on the Thailand-Myanmar borderen_US
dc.typeJournal articleen_US
dc.type.descriptionC1 - Articlesen_US
dcterms.bibliographicCitationMcGready, R; Rijken, MJ; Turner, C; Than, HH; Tun, NW; Min, AM; Hla, S; Wai, NS; Proux, K; Min, TH; Gilder, ME; Sneddon, A, A mixed methods evaluation of Advanced Life Support in Obstetrics (ALSO) and Basic Life Support in Obstetrics (BLSO) in a resource-limited setting on the Thailand-Myanmar border, Wellcome Open Research, 2021, 6, pp. 94en_US
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/en_US
dc.date.updated2021-06-27T22:19:04Z
dc.description.versionVersion of Record (VoR)en_US
gro.rights.copyright© 2021 McGready R et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_US
gro.hasfulltextFull Text
gro.griffith.authorSneddon, Anne E.


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