Annual Report 2008 - 2009 - Liverpool School of Tropical Medicine

CHILD AND
REPRODUCTIVE
HEALTH GROUP
MATERNAL AND NEWBORN
HEALTH UNIT
LSTM’s Maternal and Newborn Health Unit
(MNHU) consists of six academic and three
support staff, Nynke van den Broek (Head),
Jan Hofman, Charles Ameh, Adetoro Adegoke,
Emma Hulme, Joanna Raven, Gillian Blackman,
Sue Cain and Kristian Godfrey. This active and
rapidly expanding unit is concerned with three
key strategic areas in the area of Maternal and
Newborn Health – Skilled Birth Attendance,
Essential Obstetric Care and Quality of Care.
Contributing to the global movement to reduce
the burden of disease from pregnancy and
childbirth, MNHU conducts research, teaching
and provides technical assistance.
Malaysian Successes for MNHU
The Royal College of Obstetricians and
Gynaecologists (RCOG), MNHU and the
Department of Making Pregnancy Safer at
WHO, have developed a training programme
to improve health care provider capacity in
developing countries. Just a year after the first
‘Life Saving Skills Training – Essential Obstetric
and Newborn Care & Training of Trainers’ in
Malaysia, the course already has a life of its own
and is well on the way to raising the standard of
maternal and newborn health in the country.
Having been successfully introduced to seven
sub-Saharan African countries the course is now
being adapted and scaled up nationally in the
Republic of South Africa. Following an invitation
from the Obstetrical and Gynaecological
Society of Malaysia, the MNHU together with
the RCOG and supported by the Ministry of
Health, Government of Malaysia, ran the first
Life Saving Skills – Emergency Obstetric Care
and Newborn Care (LSS-EOC & NC) course in
Kuala Lumpur.
Three more courses were held and attended
by 106 participants of whom 37 participated
in ‘Training of Trainers’. During that time the
participation of the RCOG International Office
– a partnership between RCOG, LSTM and
LATH – has focused mainly on monitoring and
evaluation. Whilst the first teaching team was
made up of RCOG International Office staff, the
course is now delivered by the ‘trained trainers’
from hospitals and institutions around the
country and is mainly self run.
The LSS-EOC & NC course in Malaysia has been
recognised as an important capacity tool and
is the start of a long term plan to effectively
train all levels of medical staff (nurse midwives,
doctors, clinical officers and specialists) in safe
deliveries. The success of the course in Malaysia
is also mirrored in ambitious future plans. In
2010, six doctor courses are planned as well as
the start of mixed training for medical officers
and midwives. With continued monitoring and
evaluation from the RCOG team, the LSS-EOC
&NC package has been successfully introduced
in Malaysia and in the coming years will be able
to further increase the number of skilled health
professionals providing high quality maternal
and neonatal care in south east Asia.
Training Iraqi health care providers
The MNHU, in collaboration with the UK-based
Human Relief Foundation, conducted LSS-EOC
& NC training for 32 participants from 19 public
hospitals in Iraq in October 2008. The training
was conducted in Istanbul in Turkey because
of security concerns in Iraq at the time. Due
to the collapse of the health care system, the
quality and quantity of post graduate and
in-service medical training has declined very
significantly. This was an opportunity to update
health care professionals providing emergency
obstetric and new born care in major public
health care institutions with the necessary skills
and knowledge required to manage related
complications they encounter. Immediate
evaluation of the training showed that
participants enjoyed the training and indicated
that they will find the knowledge and skills
useful. The participants also showed significant
improvement in knowledge and skills after the
training.
Gender Based Violence
In Somaliland, gender based violence is
common among the IDP (Internally Displaced
Persons) and there is a high prevalence of
female genital cutting in Somalia. In addition
a low contraceptive prevalence rate is a
significant contributor to high maternal and
newborn mortality. As part of the support to
an EU funded programme aimed at improving
the sexual and reproductive health of IDPs
in Maroodi Jeex, Somaliland, the MNHU
conducted interactive training workshops
for mixed groups of medical officers, nurses
and midwives who provide related services
for the residents of five IDP settlements. The
workshops, held in June 2009 in Hargeisa,
Somaliland, covered the provision of family
planning services, psychological support
and counselling for victims of gender based
violence and the management of complications
from female genital cutting.
8 LSTM ANNUAL REPORT