Dr. Sami Mahmoud Abdelkhair ALSO®Sudan Dr. Sami Mahmoud Abdelkhair Clinical MD Consultant OBGYN Khartoum , Sudan Salzburg Medical Leadership Seminar 2014

SUDAN

New map of Sudan ALSO® International 2012 

Sudan at a glance Poor health MDGs indicators Life expectancy 56 years Low coverage and access to PHC services (45-60% -2004) MMR has reached 1140/100.000 . IMR 68/1.000 U-5 MR 104/1.000 Low level of health expenditure (less than 0.9% GDP) Health scene is dominated by communicable diseases Multiple factors affect WHY a woman dies during pregnancy. The “three delays” model”: Delay in decision to see care: lack of information about problems/warning signs, social factors Delay in reaching care: having transportation, road conditions Delay in receiving care: lack of equipment or personnel at facility, lack of funding, poor attitude of personnel

Recognition

Recognition Referral

Recognition Referral Responsiveness

1) What is the objective - in other words, what are we trying to change?

Multiple factors affect WHY a woman dies during pregnancy. The “three delays” model”: Delay in decision to see care: lack of information about problems/warning signs, social factors Delay in reaching care: having transportation, road conditions Delay in receiving care: lack of equipment or personnel at facility, lack of funding, poor attitude of personnel

Obstetric Emergency Training

ALSO® Sudan Advanced Life Support in Obstetrics ALSO® Sudan was established in 2004 ALSO courses in Sudan are run under license from the American Academy of Family Physicians (AAFP), which is leased to the Faculty of Medicine, University of Khartoum. Salzburg Medical Leadership Seminar 2014

Salzburg Medical Leadership Seminar 2014 ALSO Sudan team Dr. Abubakr Elmardi , Dr. Hassan Shehata, Dr. Badrelldin Ahmed, Dr. Hisham Mirghani , Dr. Siddig Adam. Dr. Reem Mansour , Dr. Nayla Abusalih , Dr.Abdelrahman Mageed , Dr.Basheer Elgaily , Dr. Atif Fazari Salzburg Medical Leadership Seminar 2014

ALSO® Providers and Instructors course There are 53 ALSO® providers courses 1487 candidates trained since implementation. There are eight ALSO® instructors courses 230 trained instructors since implementation Salzburg Medical Leadership Seminar 2014

Other Training in Sudan Parallel to the ALSO course , our instructors usually organize one day course for midwives in Arabic language . This is often performed in remote states of Sudan where midwives lack training in many fields like : Episiotomy & perineal repair , EMOC & infection control. Salzburg Medical Leadership Seminar 2014

Our Successes We have accomplished our training goals in terms of No. of courses & candidates. Managed to buy new sets of six mannequins (6000 sterling) Updated new ALSO manual 2012 edition. More states were covered in the peripheral parts of Sudan. We reduced the tuition fees for the candidates. (200$) Salzburg Medical Leadership Seminar 2014

Challenges/Barriers Instructors are working on voluntary basis.(Not paid at all) The ALSO is not yet incorporated in the formal training for all residents by the Sudan National Specialization board. Still many candidates can not pay the tuition fees which is 40 USA $ . Some Paramedics can not apply for the course because it is in English language. Salzburg Medical Leadership Seminar 2014

Future Forward Wider coverage of all Sudan states e.g. ALSO in Darfur state is a real challenge. More collaboration with other African countries to exchange expertise. Incorporate the ALSO as a Mandatory program in the curriculum of different medical schools. ALSO course in Arabic language. Adoption of the ALSO by FMOH. Salzburg Medical Leadership Seminar 2014

what were the results and what did We learn ?

Maternal Mortality 260/100,000 ???

The Impact of ALSO on our Performance Shahad Mahmoud Hussien - MRCOG Sami Mahmoud Abdel-Khair - MD

THE IMPACT OF ALSO ON INSTRUCTOR’S ATTITUDE

Two Sudanese Midwives attending a training course in UK in 1954 Salzburg Medical Leadership Seminar 2014