title: Focused maternal ultrasound by midwives in rural Zambia.
abstract: Point-of-care ultrasound is being increasingly implemented in resource-poor settings in an ad hoc fashion. We developed a focused maternal ultrasound-training program for midwives in a rural health district in Zambia. Four hundred forty-one scans were recorded by 21 midwives during the 6-month study period. In 74 scans (17%), the ultrasound findings prompted a change in clinical decision-making. Eight of the midwives were evaluated with a 14-question observed structured clinical examination (OSCE) and demonstrated a slight overall improvement with mean scores at 2 and 6 months of 10.0/14 (71%) and 11.6/14 (83%), respectively. Our pilot project demonstrates that midwives in rural Zambia can be trained to perform basic obstetric ultrasound and that it impacts clinical decision-making. Ultrasound skills were retained over the study period. More data is necessary to determine whether the introduction of ultrasound ultimately improves outcomes of pregnant women in rural Zambia.
authors.affiliation: Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA 02115, USA. hkimberly@partners.org
authors.forename: Heidi Harbison
authors.initials: HH
authors.lastname: Kimberly
authors.forename: Alice
authors.initials: A
authors.lastname: Murray
authors.forename: Maria
authors.initials: M
authors.lastname: Mennicke
authors.forename: Andrew
authors.initials: A
authors.lastname: Liteplo
authors.forename: Jason
authors.initials: J
authors.lastname: Lew
authors.forename: J Stephen
authors.initials: JS
authors.lastname: Bohan
authors.forename: Lynda
authors.initials: L
authors.lastname: Tyer-Viola
authors.forename: Roy
authors.initials: R
authors.lastname: Ahn
authors.forename: Thomas
authors.initials: T
authors.lastname: Burke
authors.forename: Vicki E
authors.initials: VE
authors.lastname: Noble
mesh_terms: D005260:Female; D006801:Humans; D008880:Midwifery / Q000706:statistics & numerical data*; D009035:Mothers; D010865:Pilot Projects; D011247:Pregnancy; D012424:Rural Population / Q000706:statistics & numerical data*; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*; D015024:Zambia / Q000453:epidemiology