National scale up and evaluation of EmOC programme

Project 19 Feb 2021
Mentorship Kenya

A randomised controlled trial of an intervention to improve the emergency obstetric care knowledge and skills of midwifery students prior to graduation in Kenya  

An estimated 289,000 maternal deaths, 2.6 million stillbirths and 2.4 million newborn deaths occur globally each year, with most occurring around the time of childbirth. Kenya continues to have a high level of maternal and newborn death; maternal mortality was estimated at 510 per 100,000 live births in 2015 and child mortality to be 52 per 1,000 live births. This means that an estimated 6,000 to 8,000 pregnant women die in Kenya every year. The medical and surgical interventions to prevent these deaths are known, and most maternal and newborn deaths are in principle preventable.

Providing emergency obstetric and newborn care (EmONC) by skilled birth attendants is known to reduce maternal and newborn mortality. The Kenyan government has included emergency obstetric and newborn care as a priority in their National Health Strategy. In 2012, the Ministry of Health in Kenya adapted the Liverpool School of Tropical Medicine (LSTM) EmONC training package and produced national curriculum/guidelines in 2014 for implementation nationally.

However, the focus has been on in-service EmONC capacity building. To improve the effectiveness of periodic in-service EmONC training programmes, EmONC must be adequately covered within pre-service midwifery and medical curriculum and adequately taught in training institutions. LSTM has previously supported several midwifery training institutions in Kenya to improve the content and quality of EmONC training within their curriculum. However, the effect of these interventions has not been determined.

Although there have been two studies evaluating the effectiveness of EmONC training for pre-service students but generalising the results is limited by the type of participants included (medical students and interns) and weak study designs. The aim of this study is to examine the effectiveness of EmONC training and to see if it improves the skills and knowledge of participants.