ArticleBulletin of the World Health Organization2019
Local adaption of intrapartum clinical guidelines, United Republic of Tanzania.
Article in Bulletin of the World Health Organization, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quality and women's satisfaction with maternal referral practices in sub-Saharan African low and lower-middle income countries: a systematic review.BMC pregnancy and childbirth · 2020Pooled it
- The Dilemmas and Opportunities of Co-Creating Health Interventions to Fit Local Contexts: An Ethnographic Study on the Adaptation of Clinical Guidelines in Tanzania.Health expectations : an international journal of public participation in health care and health policy · 2024Trial
- New Antenatal Model in Africa and India (NAMAI) study: implementation research to improve antenatal care using WHO recommendations.Health research policy and systems · 2023Trial
- The PROMISE study: protocol for a community-based cohort study and co-creation of a reproductive health intervention in Somaliland.Global health action · 2026Article
- Toward Labour-Care Tools That Survive Low-Resource Realities: Reflections From the PartoMa Group on the WHO Labour Care Guide Implementation Strategy.Birth (Berkeley, Calif.) · 2026Article
- Coadaptation and implementation of intrapartum clinical guidelines to save lives during childbirth: Protocol for an adapted PartoMa intervention in Eastern Ethiopia.BMC health services research · 2026Article
- Emergency, critical and operative care in Afghanistan: pathways to overcoming fragmentation and strengthening access in a post-conflict setting-a mixed-method study.BMJ public health · 2026Article
- Effectiveness of dissemination strategies of maternal clinical guidelines: A narrative review.African journal of primary health care & family medicine · 2024Review
- Temporalities of oxytocin for labour augmentation: a mixed-methods study of time factors shaping labour practices in a busy maternity unit in Tanzania.BMC pregnancy and childbirth · 2024Article
- Characteristics and outcomes of pregnant women hospitalized with severe maternal outcomes in eastern Ethiopia: Results from the Ethiopian Obstetric Surveillance System study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2024Article
- Strategies to improve interpersonal communication along the continuum of maternal and newborn care: A scoping review and narrative synthesis.PLOS global public health · 2023Article
- Article
- Scaling up Locally Adapted Clinical Practice Guidelines for Improving Childbirth Care in Tanzania: A Protocol for Programme Theory and Qualitative Methods of the PartoMa Scale-up Study.Global health action · 2022Article
- The impact of training on self-reported performance in reproductive, maternal, and newborn health service delivery among healthcare workers in Tanzania: a baseline- and endline-survey.Reproductive health · 2022Article
- The injustice of unfit clinical practice guidelines in low-resource realities.The Lancet. Global health · 2021Review
- Learning from changes concurrent with implementing a complex and dynamic intervention to improve urban maternal and perinatal health in Dar es Salaam, Tanzania, 2011-2019.BMJ global health · 2021Article
- Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations.International journal of environmental research and public health · 2020Article
- Building a Digital Tool for the Adoption of the World Health Organization's Antenatal Care Recommendations: Methodological Intersection of Evidence, Clinical Logic, and Digital Technology.Journal of medical Internet research · 2020Article
- Impact of COVID-19 on maternal and child health.The Lancet. Global health · 2020Article
- Birth asphyxia following delayed recognition and response to abnormal labour progress and fetal distress in a 31-year-old multiparous Malawian woman.BMJ case reports · 2019Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
problemGaps exist between internationally derived clinical guidelines on care at the time of birth and realistic best practices in busy, low-resourced maternity units. APPROACH: In 2014-2018, we carried out the PartoMa study at Zanzibar's tertiary hospital, United Republic of Tanzania. Working with local birth attendants and external experts, we created easy-to-use and locally achievable clinical guidelines and associated in-house training to assist birth attendants in intrapartum care. LOCAL
settingAround 11 500 women gave birth annually in the hospital. Of the 35-40 birth attendants employed, each cared simultaneously for 3-6 women in labour. At baseline (1 October 2014 to 31 January 2015), there were 59 stillbirths per 1000 total births and 52 newborns with an Apgar score of 1-5 per 1000 live births. Externally derived clinical guidelines were available, but rarely used. RELEVANT CHANGES: Staff attendance at the repeated trainings was good, despite seminars being outside working hours and without additional remuneration. Many birth attendants appreciated the intervention and were motivated to improve care. Improvements were found in knowledge, partograph skills and quality of care. After 12 intervention months, stillbirths had decreased 34% to 39 per 1000 total births, while newborns with an Apgar score of 1-5 halved to 28 per 1000 live births. LESSONS LEARNT: After 4 years, birth attendants still express high demand for the intervention. The development of international, regional and national clinical guidelines targeted at low-resource maternity units needs to be better attuned to input from end-users and the local conditions, and thereby easier to use effectively.
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