Emergency obstetrics knowledge and practical skills retention among hospital and clinic staff following advanced life support obstetrical training in Cameroon, Africa

Abstract

Background: Although worldwide rates have decreased, maternal mortality remains a major public health challenge in many resource limited countries. In 2015, Cameroon had the 10th highest maternal mortality rate ranking in the world. The “three delays” model identifies common barriers to accessing emergency obstetrical care (EmOC): 1. a delay in the decision to seek emergency care; 2. a delay in reaching emergency care; and, 3. a delay in being providing safe and adequate emergency care in the health facility. This study addresses the 3rd delay: providing safe and appropriate EmOC in the health care facility. Method: The Advanced Life Support in Obstetrics (ALSO) is an internationally recognized course which provides training for health care workers (HCW) to manage emergency obstetrical conditions. The ALSO course was made available by the Cameroon Baptist Convention Health Services to any health care facility who wished to send their HCW’s for emergency obstetrical training. This study investigates the retention of knowledge and skills among these HCW’s, 6-31 months, after completing the course. Results: From May 2012 to December 2014, 156 HCW’s completed the ALSO training course with 99 (64.5%) participating in this knowledge and skill retention study. The HCW’s perceived the training to be beneficial (95.9%) and identified utilizing some of the skills taught (90.8%). The skill maintenance was measured by the HCW’s ability to pass the ALSO practical skill retest. The HCW skill pass rate decreased from 65.4% at the initial training to 34.6% on retest (P= 0.006). Skill maintenance was associated with individual …