A systematic review of the effectiveness of training in emergency obstetric care in low-resource environments
Article first published online: 20 APR 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 117, Issue 7, pages 777–787, June 2010
How to Cite
van Lonkhuijzen, L., Dijkman, A., van Roosmalen, J., Zeeman, G. and Scherpbier, A. (2010), A systematic review of the effectiveness of training in emergency obstetric care in low-resource environments. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 777–787. doi: 10.1111/j.1471-0528.2010.02561.x
- Issue published online: 10 MAY 2010
- Article first published online: 20 APR 2010
- Accepted 26 February 2010. Published Online 20 April 2010.
- emergency obstetric care;
- maternal mortality;
- millennium development goals;
Please cite this paper as: van Lonkhuijzen L, Dijkman A, van Roosmalen J, Zeeman G, Scherpbier A. A systematic review of the effectiveness of training in emergency obstetric care in low-resource environments. BJOG 2010;117:777–787.
Background Training of healthcare workers can play an important role in improving quality of care, and reducing maternal and perinatal mortality and morbidity.
Objectives To assess the effectiveness of training programmes aimed at improving emergency obstetric care in low-resource environments.
Search strategy We searched Pubmed, Embase, Popline and selected websites, and manually searched bibliographies of selected articles. Language was not an exclusion criterion.
Selection criteria All papers describing postgraduate training programmes aimed at improving emergency obstetric care in low-resource environments were included.
Data collection and analysis Two reviewers independently extracted the data and classified these according to the level of the measured effects (reaction of participants, improved knowledge and skills, changes in behaviour and outcomes in practice). Any disagreements were resolved by discussion with a third author until agreement was reached.
Main results A total of 38 papers were selected. Training programmes vary considerably in length, content and design. The evaluation of effects is often hampered by inadequate study design and the use of non-validated measuring instruments. Most papers describe positive reactions, increased knowledge and skills, and improved behaviour after training. Outcome is assessed less frequently, and positive effects are not always demonstrated. Measures that can contribute to a positive effect of training programmes include hands-on practise, team approaches and follow-up on training efforts.
Author’s conclusions Training programmes may improve quality of care, but strong evidence is lacking. Policymakers need to include evaluation and reporting of effects in project budgets for new training programmes.