Abstract
Anaesthesia has been shown to contribute disproportionately to maternal mortality in low-resource settings. This figure exceeds 500 per 100,000 live births in Tanzania, where anaesthesia is mainly provided by non-physician anaesthetists, many of whom are working as independent practitioners in rural areas without any support or opportunity for continuous medical education. The three-day Safer Anaesthesia from Education (SAFE) course was developed to address this gap by providing in-service training in obstetric anaesthesia to improve patient safety. Two obstetric SAFE courses with refresher training were delivered to 75 non-physician anaesthetists in the Mbeya region of Tanzania between August 2019 and July 2020. To evaluate translation of knowledge into practice, we conducted direct observation of the SAFE obstetric participants at their workplace in five facilities using a binary checklist of expected behaviours, to assess the peri-operative management of patients undergoing caesarean deliveries. The observations were conducted over a 2-week period at pre, immediately post, 6-month and 12-month post-SAFE obstetric training. A total of 320 cases completed by 35 participants were observed. Significant improvements in behaviours, sustained at 12 months after training included: pre-operative assessment of patients (32% (pre-training) to 88% (12 months after training), p
Original language | English |
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Pages (from-to) | 1354-1364 |
Number of pages | 11 |
Journal | Anaesthesia |
Volume | 78 |
Issue number | 11 |
Early online date | 10 Jul 2023 |
DOIs | |
Publication status | Published - Nov 2023 |
Bibliographical note
Funding Information:The study was funded by the Laerdal Foundation. ML and AZ are joint first authors. We would like to thank the World Federation of Societies of Anaesthesiologists and the Association of Anaesthetists, UK for operational and administrative support. We would also like to express our deepest gratitude to the faculty and research assistants: B. Asnake, A. Chamwanzi, A. Cheng, T. Kasole, K. Khalid, L. Frostan Komba, C. L. S. Kwan, A. F. Lwiza, P. Massawe, B. McKenna, S. S. Mohamed, C. Msadabwe, P. Murambi, A. Musgrave, M. C. Mutagwaba, G. Mwakisambwe, A. S. Ndebeya, S. G. Ndezi, H. Phiri, P. Ponsian, R. Samwel, E. Shang'a and R. Swai. This paper is dedicated to the memory of our dear friend and colleague, Soloman Gerald Ndezi (1984–2022), who was a dedicated teacher and compassionate doctor. No competing interests declared.
Keywords
- CME
- in-service training
- knowledge translation
- LMIC
- obstetric anaesthesya
- SAFE