1. SAFE Obstetrics Course: Education aimed at reducing maternal mortality in Zambia
EL Coley1, R Colhoun2, P Bonnett2
1. Anaesthesia, University Teaching Hospital, Lusaka, Zambia
2. Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
Introduction
Maternal mortality in Zambia remains unacceptably high at 280 per live births.1 Despite significant progress there is still work to be done to reduce maternal mortality in line with the World Health Organisation’s (WHO) Millennium Development Goals. The Lancet Commission on Global Surgery also highlighted the international lack of anaesthesia capacity.2 In an effort to reduce mortality and improved anaesthetic care through education, we have delivered the Lifebox and the AAGBI’s SAFE (Safe Anaesthesia From Education) obstetric anaesthesia courses to the majority of anaesthetic providers within Zambia
Methods
Zambian and UK-based clinicians formed a joint faculty to deliver the courses. The one-day Lifebox course promotes the WHO surgical checklist and emphasises the importance of pulse oximeter monitoring. The three-day SAFE obstetric anaesthesia course aims to improve the safety of obstetric anaesthetic care provision and employs lectures, simulation and workshops to deliver teaching. Participants were asked to complete a pre-course and post-course multiple choice question (MCQ) test and a simulated scenario test. Pre and post-course test scores were analysed using paired students t-test for statistical significance.
Results
A total of 124 Zambian anaesthetic providers attended the combined Lifebox/SAFE obstetrics anaesthesia courses over a period of two years; participants were a mixture of physicians and clinical officers (specialist nurses). Scores of all participants improved following education with statistically significant improvement in all test areas (p<0.005)
Discussion
References
We have demonstrated that the courses delivered are effective in improving skills and knowledge of the participants who attend. Our long-term aim is to establish a sustainable programme of SAFE anaesthetic courses, delivered by Zambian clinicians, to run on a twice-yearly basis. Funding for this has been secured from the Zambian Ministry of Health. It is hoped that widespread training amongst anaesthetic providers will help to reduce maternal mortality attributable to anaesthetic causes.
1. World Health Organisation. 
2. Meara JG, Leather AJM, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. The Lancet, Vol. 386, No. 9993, p569–624
Acknowledgements
We would like to thank the AAGBI, Lifebox, THET and the Zambian Minsitry of Health for all their support.