222067 Multidisciplinary Team Partnership to Strengthen Maternal and Neonatal Health and Improve Outcomes: The Kybele Experience

Tuesday, November 9, 2010

Cyril M. Engmann, MD FAAP , Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina Schools of Medicine and Public Health, Chapel Hill, NC
Adeyemi Olufolabi, MD FRCA , Division of Womens Anesthesia, Duke University, Durham, NC
Emmanuel Srofenyoh, MD FWACS , Department of Obstetrics and Gynaecology, Ridge Hospital, Accra, Ghana
Medge Owen, MD FASA , Division of Obstetric Anesthesia, Wake Forest University Medical Center, Winston-Salem, NC
Objective Kybele, Inc. is a 501 (c) (3) non-profit humanitarian organization dedicated to improving childbirth conditions worldwide through medical education partnerships. We describe the Kybele multidisciplinary team partnership to improve maternal and neonatal outcomes in Ghana. Information used/Methods Kybele, Inc. has a growing volunteer trainer base currently at 251 participants in five years. Faculty - anesthesiologists, obstetricians, nurses, midwives, neonatologists, internists, biomedical engineers and administrators come from 55 institutions in the US, Canada, UK and Australia. Kybele entered a 5-year agreement in 2007 with the Ghana Health Service to establish Obstetric Centers of Excellence to reduce maternal and neonatal deaths by half. The evolution of Kybele's activities at Ridge Hospital, the flagship tertiary referral hospital of the Ghana Health Service in the Greater Accra Health Region, is described.

Results Twelve areas for improvement were identified by a multidisciplinary Ghanaian-Kybele team, and twelve interventions devised and instituted. Subsequently, there has been an explosion of activities in domains of quality improvement, clinical guideline development, standard operating procedures, teaching and training, advocacy, research and patient centered care. Despite a tripling of deliveries at Ridge Hospital from 2005 2009, with no influx of new staff, maternal mortality rates have decreased by 36 % and perinatal mortality rates are nearly halved. Conclusion The rich collaborative, multidisciplinary partnerships forged against the backdrop of a systems improvement philosophy, are responsible for the remarkable achievements of Kybele in Ghana. While much more needs to be done, there is cause for guarded optimism.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1)Identify the challenges facing midwives and physicians working in resource-constrained environments. 2)Describe the role of multidisciplinary team partnerships in combating maternal and perinatal morbidity and mortality. 3)Discuss the use of systems improvement methodology to improve maternal and perinatal health.

Keywords: International Health, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I practice, teach, research and publish in international health work, and oversee projects in disease prevention, systems improvement and reducing perinatal morbidity and mortality.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.