title: Evidence for improvement in the quality of care given during emergencies in pregnancy, infancy and childhood following training in life-saving skills: a postal survey.
abstract: OBJECTIVE
  To assess the motivational level and use of skills amongst the graduates of training courses on maternal and newborn healthcare in emergency settings.
  
  
  METHODS
  Postal survey involving Doctors and Nurses from public sector hospitals who attended training courses on Essential Surgical Skills with emphasis on Emergency Maternal and Child Health.
  
  
  RESULTS
  Ninety percent of respondents reported the use of acquired skills and the structured Airway, Breathing, Circulation (ABC) approach in handling emergencies. Instances were described where this approach helped to improve practice, simplify treatment and save lives in all age groups, especially mothers and newborns. Lack of equipment and lack of support from higher levels were the common barriers yet many graduates managed to obtain equipment and 81% of respondents reported that these training courses had resulted in better availability or use of supplies at their facilities. Efforts were made by the graduates for institutionalizing the trainings and discussions (88%) were found to be the most common mode followed by formal teaching of the skills (66%). Hand washing was the most commonly used skill followed by the use of bag valve and mask resuscitation in the newborn at birth. Those catering for neonates expressed their confidence in obstetric procedures, while obstetricians described themselves as being self-assured now in neonatal resuscitation.
  
  
  CONCLUSIONS
  The introduction of a structured training programme in a resource-constrained healthcare system has improved the emergency management of patients. ESS-EMCH trainings should be incorporated into the district health systems to enhance emergency care handling capacities of healthcare staff, to help them contribute to achieve the MDGs and also for sustainable improvement in maternal, neonatal and child healthcare.
authors.affiliation: Johns Hopkins University Center for Communication Programs, Islamabad.
authors.lastname: Zaeem-ul-Haq
authors.forename: Farrukh
authors.initials: F
authors.lastname: Qureshi
authors.forename: Assad
authors.initials: A
authors.lastname: Hafeez
authors.forename: Shamsa
authors.initials: S
authors.lastname: Zafar
authors.forename: Bile Khalif
authors.initials: BK
authors.lastname: Mohamud
authors.forename: David P
authors.initials: DP
authors.lastname: Southal
mesh_terms: D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000592:standards*; D055318:Evidence-Based Nursing; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D024802:Nurse's Role; D009732:Nursing Care / Q000592:standards*; D010154:Pakistan; D011247:Pregnancy; D011787:Quality of Health Care / Q000592:standards*; D011795:Surveys and Questionnaires