title: Turning Disaster into an Opportunity for Quality Improvement in Essential Intrapartum and Newborn Care Services in the Philippines: Pre- to Posttraining Assessments.
abstract: Background. On 8 November 2013, supertyphoon Haiyan made landfall in the Philippines, severely disrupting health service delivery. Reestablishment of essential services for birthing mothers and their newborns became high priority. Methodology. Following a baseline assessment, an Essential Intrapartum and Newborn Care (EINC) training package was implemented and posttraining assessments (1 and 3 months after training) were undertaken. Results. Baseline assessments (n = 56 facilities) revealed gaps in provider's skill and shortage of life-saving commodities. Facilities lacked newborn bags/masks (9%), towels (6%), and magnesium sulfate (39%). Service providers lacked skills in partograph use (54%), antenatal steroid (44%) use, and breastfeeding initiation (50%). At 3 months after training (n = 51 facilities), dramatic increases in correct partograph use (to 92%), antenatal steroid use (to 98%), breastfeeding initiation (to 86%), kangaroo mother care (to 94%), availability of magnesium sulfate (to 94%), and bag/masks (to 88%) were documented. Gaps persisted for skills in assisted vaginal delivery and removal of placental fragments. Conclusion. Health services were severely disrupted after supertyphoon Haiyan. Our study demonstrates that essential birthing services and quality improvements to strengthen local health systems can be restored in a timely manner even in immediate postdisaster settings.
authors.affiliation: UNICEF Philippines, 1200 Makati, Philippines.
authors.forename: M S
authors.initials: MS
authors.lastname: Castillo
authors.affiliation: Kalusugan ng Mag-Ina, Inc. (Health of Mother and Child), 1103 Quezon City, Philippines; Remedios T. Romualdez Medical Foundation (RTRMF), College of Medicine, 6500 Tacloban, Philippines.
authors.forename: M A
authors.initials: MA
authors.lastname: Corsino
authors.affiliation: Department of Health Disease Prevention and Control Bureau, 1003 Manila, Philippines.
authors.forename: A P
authors.initials: AP
authors.lastname: Calibo
authors.affiliation: UNICEF Philippines, 1200 Makati, Philippines; Department of Obstetrics and Gynaecology, Medical University of Graz, 8010 Graz, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Zeck
authors.affiliation: Kalusugan ng Mag-Ina, Inc. (Health of Mother and Child), 1103 Quezon City, Philippines.
authors.forename: D S
authors.initials: DS
authors.lastname: Capili
authors.affiliation: Department of Health Regional Health Office 8 (Eastern Visayas), Palo, 6501 Leyte, Philippines.
authors.forename: L C
authors.initials: LC
authors.lastname: Andrade
authors.affiliation: Kalusugan ng Mag-Ina, Inc. (Health of Mother and Child), 1103 Quezon City, Philippines; Alliance for Improving Health Outcomes Inc., 1104 Quezon City, Philippines.
authors.forename: K A
authors.initials: KA
authors.lastname: Reyes
authors.affiliation: Kalusugan ng Mag-Ina, Inc. (Health of Mother and Child), 1103 Quezon City, Philippines.
authors.forename: R C
authors.initials: RC
authors.lastname: Alfonso
authors.affiliation: UNICEF Philippines, 1200 Makati, Philippines.
authors.forename: M B
authors.initials: MB
authors.lastname: Ponferrada
authors.affiliation: Kalusugan ng Mag-Ina, Inc. (Health of Mother and Child), 1103 Quezon City, Philippines.
authors.forename: M A
authors.initials: MA
authors.lastname: Silvestre
mesh_terms: D001942:Breast Feeding / Q000379:methods; D004190:Disasters; D004493:Education / Q000379:methods*; D006296:Health Services; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007231:Infant, Newborn; D010679:Philippines; D011181:Postnatal Care / Q000379:methods