246204 Evaluation of the Advanced Life Support for Obstetrics (“ALSO”) Program in the State of Oaxaca, Mexico

Monday, October 31, 2011: 12:48 PM

Paola Sesia, PhD, MPH , Pacífico Sur unit, CIESAS, Mexico, Oaxaca, Mexico
Marieke G. Van Dijk, MD, MA , Population Council, Mexico, Mexico
Mónica Iliana García-Rojas, Md, MSc , Servicios de Salud de Oaxaca, Oaxaca Ministry of Health, Oaxaca, Mexico
Matthias Sachse-Aguilera, MD , Pacífico Sur unit, CIESAS, Mexico, Oaxaca, Mexico
Karla Berdichevsky, MD, MPH , Population Council Mexico Office, Mexico City, Mexico
Xipatl Contreras, BA , Population Council Mexico Office, Mexico City, Mexico
Jorge Valencia, MSc , Population Council Mexico Office, Mexico City, Mexico
Sandra Garcia, ScD, ScM , Population Council Mexico Office, Mexico City, Mexico
Although Mexico is considered a middle-income country, its maternal and newborn mortality rates are still too high, especially in rural states such as Oaxaca. In line with the focus of the Federal Ministry of Health (MOH) on adequate care for obstetric emergencies (EmOC), in 2009 the Oaxaca MOH adopted the “Advanced Life Support for Obstetrics” (ALSO) program for Ob/Gyns and general physicians as the main strategy for improving technical skills in EmOC and decreasing maternal mortality. The ALSO course is generally recognized as having a beneficial effect on EmOC; however, the impact of the course has never been systematically assessed. ALSO has been offered to over 400 medical providers in the state of Oaxaca, and over 50% of the Ob/Gyns that are presently working at the state's main referral hospital are certified in ALSO. Through a combination of direct observation of management of obstetric emergencies of ALSO-trained versus untrained physicians in this hospital, medical chart reviews, surveys mapping medical supplies, equipment, and available health personnel, and in-depth interviews with MOH and hospital authorities, we are evaluating whether ALSO courses are effective in improving the technical skills and working morale of participating providers in EmOC; especially hemorrhage and severe preeclampsia/eclampsia. We have completed over sixty observations, have started the medical charts' review and have finalized the survey. We are now analyzing the findings and we expect to have final data by September 2011.

Learning Areas:
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe the effectiveness of the ALSO course in improving technical skills and working morale of participating providers in the management of obstetric emergencies. List the main challenges in the implementation of skills taught by ALSO. Formulate recommendations that could help improve the effectiveness of the ALSO course.

Keywords: Maternal Care, Health Care Delivery

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a master's degree in medicine and medical anthropology, and I am working as a regional research associate with the Population Council. I have been the co-PI of the present study, and have relevant experience concerning maternal mortality research, and research on other reproductive and sexual health issues.
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.