title: Continuing professional education in Eritrea taught by local obstetrics and gynaecology residents: Effects on work environment and patient outcomes.
abstract: Education and training can improve the quality of health care. We evaluated a course taught by Obstetrics/Gynaecology residents on the work environment and maternal/neonatal outcomes at Orotta Maternity Hospital. Participants were given a Standardised Safety Attitudes Questionnaire (SAQ) to measure work environment before and after training. Maternal/neonatal outcomes were extracted from hospital logbooks. Neonatal quality indicators were: adverse score index, weighted score index and severity score index. SAQ response rate was 77.6% (45/58) pre-training and 95.6% (43/45) post-training. Mean total SAQ score increased from 3.07 to 3.32 out of 5 points (p < 0.05). Changes in relative risk (RR) were not statistically significant for maternal [maternal death ratio of RR (RRR) =1.08, 95% CI: 0.20-5.84 and blood transfusion RRR = 0.90, 95% CI: 0.74 -1.09] or neonatal outcomes (intrapartum death RRR = 1.24, 95% CI: 0.57-2.75, neonatal death RRR = 0.93, 95% CI: 0.26-3.24, neonatal transfer RRR = 1.02, 95% CI: 0.81-1.27, and Apgar < 7 at 5 minutes RRR = 1.20, 95% CI: 0.83-1.73). Neonatal quality indicators did not change significantly. Utilising residents to teach staff-developed training within a hospital setting was feasible and may improve the work environment. Impact on maternal/neonatal outcomes is not evident but continued follow-up is important.
authors.affiliation: a Department of Obstetrics/Gynecology , Orotta Postgraduate Medical Education , Asmara , Eritrea.
authors.forename: Susan
authors.initials: S
authors.lastname: Marzolf
authors.forename: Berhane
authors.initials: B
authors.lastname: Zekarias
authors.forename: Kifleyesus
authors.initials: K
authors.lastname: Tedla
authors.forename: Dawit Estifanos
authors.initials: DE
authors.lastname: Woldeyesus
authors.forename: Dawit
authors.initials: D
authors.lastname: Sereke
authors.forename: Abraham
authors.initials: A
authors.lastname: Yohannes
authors.forename: Kibreab
authors.initials: K
authors.lastname: Asrat
authors.forename: Marcia R
authors.initials: MR
authors.lastname: Weaver
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004502:Education, Medical, Continuing / Q000379:methods / Q000458:organization & administration; D019017:Eritrea; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D000068104:Infant Health / Q000639:trends; D007231:Infant, Newborn; D007396:Internship and Residency; D008297:Male; D000068097:Maternal Health / Q000639:trends; D008505:Medical Staff, Hospital / Q000193:education; D008875:Middle Aged; D009774:Obstetrics / Q000193:education*; D061214:Patient Safety / Q000592:standards; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D019984:Quality Indicators, Health Care; D055815:Young Adult
keywords: developing country; education; maternal and neonatal outcomes; resident-led teaching; work environment