title: Implementing an obstetric ultrasound training program in rural Africa.
abstract: OBJECTIVE
  To evaluate the feasibility and sustainability of basic obstetric ultrasound training in rural Africa.
  
  
  METHODS
  An 8-week training course, led by UK-based sonographers, was supported by training videos and followed by 10 months of remotely supported scanning in Mandimba, Mozambique. Data were collected prospectively using an Android tablet and the EpiCollect web application.
  
  
  RESULTS
  The study group included 1744 pregnant women: 804 scanned by trainees under direct supervision and 940 scanned by trainees alone. Ultrasound identified 36 (2.1%) twin pregnancies, 230 (13.2%) breech presentations, 83 (4.8%) transverse presentations, and 22 (1.3%) cases of placenta previa. The detection rates for the above features were similar in the 2 groups. A subgroup of 230 (13.2%) women had a follow-up scan and 62 (3.6%) were referred to a doctor; 21 of these women required cesarean delivery.
  
  
  CONCLUSIONS
  Ultrasound training in a rural setting supported remotely is feasible, efficient, and sustainable. It can help local healthcare workers to screen their prenatal populations for obstetric and neonatal risks, and therefore has the potential to improve outcomes at delivery and provide site-specific epidemiologic data that can be used to develop new healthcare provision strategies.
authors.affiliation: Academic Department of Maternal and Fetal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, London, UK; Medical Aid Films, London, UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Greenwold
authors.affiliation: Medical Aid Films, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wallace
authors.affiliation: Medical Aid Films, London, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Prost
authors.affiliation: Academic Department of Maternal and Fetal Medicine, UCL Elizabeth Garrett Anderson Institute for Women's Health, London, UK; Medical Aid Films, London, UK. Electronic address: e.jauniaux@ucl.ac.uk.
authors.forename: Eric
authors.initials: E
authors.lastname: Jauniaux
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000193:education*; D006801:Humans; D009073:Mozambique; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011446:Prospective Studies; D019035:Rural Health Services / Q000458:organization & administration*; D016216:Ultrasonography, Prenatal / Q000379:methods*; D055815:Young Adult
keywords: Africa; Education; Fetal; Low-income countries; Obstetrics; Training; Ultrasound