Building Comprehensive Care Teams to Eliminate Preventable Maternal and Neonatal Morbidity and Mortality: Critical Components in Building Capacity
A woman in Sub-Saharan Africa (SSA) is almost 100 times more likely to die from pregnancy or childbirth-related complications than a woman in a developed country; a 1 in 39 lifetime risk compared to 1 in 3,800. These maternal deaths, as well as early neonatal deaths and complications such as obstetric fistula, are almost all preventable with skilled obstetric care. Ending preventable, maternal, perinatal and early neonatal mortality will only be realized when the most severe maternal complications can be addressed with known obstetric interventions. Only professional obstetricians/gynecologists are directly trained to provide solutions at this level, but must work in teams with midwives and health workers for a comprehensive approach. In much of SSA, the maternal and child health team is missing a critical component when a OBGYN is not a part of the care. These OBGYN physicians provide impactful, modern-day solutions as well as national leadership in the field of women’s health.
Currently, the ability and resources in SSA necessary to train this level of physician is severely lacking.
Our landmark meeting of OBGYNs from around the world that took place in Accra, Ghana in 2014 confirmed the urgent need, including institutional desire, to strengthen OBGYN departments across SSA in order to end preventable maternal and perinatal mortality. The Accra conference involved over 120 people, representatives of obstetrics and gynecology programs from the USA, Great Britain, and Sub-Saharan Africa and representatives from the Ministries of Health and Education of 14 Sub-Saharan African countries and resulted in an agreement and commitment to a shared goal of training 1000+ new OBGYNs within the next 10 years. Eliminating Preventable Maternal and Neonatal Morbidity and Mortality: Critical Components in Building Capacity details the Accra conference, the results of which highlighted the notion that the current capacity for university-based programs to train physicians to become obstetricians and gynecologists is severely lacking or completely absent in many SSA countries. It also identified the critical components for capacity building in expert women’s health care: authentic partnership, departmental infrastructure, curriculum development, faculty development in both academic and clinical roles, community and midwifery outreach with district hospital development deployment, and engagement of ministries of health and education, research to improve clinical outcomes in-country, monitoring and evaluation of community population of public health outcomes, quality improvement, and certification and involvement with professional societies. Developing residency and training programs with experienced academic partners to comprehensively implement in these 10 areas would result in a transformation of pregnancy and neonatal outcomes and improve care for thousands of women across SSA. Training an additional 1000+ OBGYNs in the 14 identified countries would jump start a dynamic process and create in-country structures and institutions to continue to supply the country with an increasing number of trained specialists to rural areas for years to come. The Ghana partnership has already proven that new sustainable capacity can be created through long-term academic partnerships. By replicating this model, a long-term solution for reducing obstetric fistula, stillbirths and maternal and early neonatal deaths can be established through the addition of a critical member, the OGBYN, to the maternal and child care team.
For more detail, please visit: https://www.researchgate.net/publication/289368114_Eliminating_Preventable_Maternal_and_Neonatal_Morbidity_and_Mortality_Critical_Components_in_Building_Capacity
