Prehospital Emergency Obstetric and Neonatal Care Train the Trainers program in Rwanda

Nov 20, 2020; International Journal of Gynecologic & Obstetrics .


To improve maternal mortality rates, our collaboration developed and implemented a context‐specific, prehospital Emergency Obstetrics and Neonatal Course (EONC) and train‐the‐trainers program in Rwanda.

Two cohorts of staff participated in the program—the SAMU emergency medical service and staff from district hospitals. A 2‐day course was developed, consisting of skills stations, simulations, and didactics. A 50‐question assessment was administered to both cohorts before and after the courses. Student's t test and matched paired t tests were used to evaluate the assessments through retrospective analysis of the data.

EONC1 median scores were 60% versus 92% (pre vs post), using matched‐pair analysis of 20 participants. EONC2 median scores were 52% versus 96% (pre vs post), using matched‐pair analysis of participants. A one‐way analysis of variance mean square analysis showed that regardless of the baseline level of training for each participant, all trainees reached similar post‐course assessment scores (F(1) = 8.35, P = 0.0059).

Optimal prehospital management of obstetric emergencies is essential to prevent needless mortality and morbidity. This study demonstrated that a context‐appropriate prehospital obstetric and neonatal training program could be effectively developed and implemented for the SAMU team in Kigali, Rwanda.

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