ArticleBMJ global health2021
Reducing surgical site infections and mortality among obstetric surgical patients in Tanzania: a pre-evaluation and postevaluation of a multicomponent safe surgery intervention.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 15 citations in OpenAlex.
- Effect of interventions on surgical site infections in Sub-Saharan Africa: a systematic review.BMC surgery · 2025Pooled it
- Epidemiology of surgical site infections post-cesarean section in Africa: a comprehensive systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Surgical site infections after caesarean section across sub-Sahara Africa: a scoping review of prevalence and associated factors.Frontiers in global women's health · 2025Pooled it
- Interdisciplinary strategies to reduce surgical site infections in operating rooms: a scoping review.BMJ open quality · 2026Article
- Surgical Solution of C-Section Associated Surgical Site Infection in LMICs: A Narrative Review.Pakistan journal of medical sciences · 2026Review
- "It's a priority": a qualitative analysis of the implementation of a maternal equity safety bundle in Massachusetts.Implementation science communications · 2025Article
- Post-operative site infections among surgical patients at Southern Ethiopia: A prospective cohort study.Heliyon · 2024Article
- The Impact of an Evidence-Based Bundle on Cesarean Section-Related Surgical Site Infections: A Randomized Clinical Trial.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2024Article
- Antimicrobial approach of abdominal post-surgical infections.World journal of gastrointestinal surgery · 2023Review
- Mentoring approaches in a safe surgery program in Tanzania: Lessons learned during COVID-19 and recommendations for the future.Surgery open science · 2023Article
- Three Pivots for Improving Health Care Provider Performance.Global health, science and practice · 2022Article
Corrections and comments
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Authors and funding
24 authors at 7 institutions in 2 countries.
Funding
Abstract
introductionDespite ongoing maternal health interventions, maternal deaths in Tanzania remain high. One of the main causes of maternal mortality includes postoperative infections. Surgical site infection (SSI) rates are higher in low/middle-income countries (LMICs), such as Tanzania, compared with high-income countries. We evaluated the impact of a multicomponent safe surgery intervention in Tanzania, hypothesising it would (1) increase adherence to safety practices, such as the WHO Surgical Safety Checklist (SSC), (2) reduce SSI rates following caesarean section (CS) and (3) reduce CS-related perioperative mortality rates (POMRs).
methodsWe conducted a pre-cross-sectional/post-cross-sectional study design to evaluate WHO SSC utilisation, SSI rates and CS-related POMR before and 18 months after implementation. Our interventions included training of inter-professional surgical teams, promoting use of the WHO SSC and introducing an infection prevention (IP) bundle for all CS patients. We assessed use of WHO SSC and SSI rates through random sampling of 279 individual CS patient files. We reviewed registers and ward round reports to obtain the number of CS performed and CS-related deaths. We compared proportions of individuals with a characteristic of interest during pre-implementation and post implementation using the two-proportion z-test at p≤0.05 using STATA V.15.
resultsThe SSC utilisation rate for CS increased from 3.7% (5 out of 136) to 95.1% (136 out of 143) with p<0.001. Likewise, the proportion of women with SSI after CS reduced from 14% during baseline to 1% (p=0.002). The change in SSI rate after the implementation of the safe surgery interventions is statistically significant (p<0.001). The CS-related POMR decreased by 38.5% (p=0.6) after the implementation of safe surgery interventions.
conclusionOur findings show that our intervention led to improved utilisation of the WHO SSC, reduced SSIs and a drop in CS-related POMR. We recommend replication of the interventions in other LMICs.
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