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| Name | Class |
|---|---|
| Mexican National Institute for Women | UNKNOWN |
| Mexican Center for Gender Equity and Reproductive Health | UNKNOWN |
| Secretary for Women, Chiapas | UNKNOWN |
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Rates and causes of maternal mortality in Mexico have dropped only slightly; thus, reaching the internationally established Millennium Development Milestones (MDM) is still a distant goal. A fundamental part of reducing maternal and infant mortality is ensuring an adequate and timely response to obstetric emergencies. PRONTO2: Obstetric and Neonatal Emergency Training Program is an innovative training strategy based on simulations designed to train hospital personnel to respond to obstetric emergencies. The objective of this study is to implement PRONTO2 in selected hospitals to measure the effectiveness of the intervention in influencing key behaviors in hospital practices, as well as measuring maternal and neonatal outcomes in intervention versus control hospitals.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | Hospitals randomized to the control arm do not receive any intervention. | |
| PRONTO training | Experimental | PRONTO training is delivered to medical teams at hospitals randomized to this arm. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PRONTO training | Other | PRONTO is an intervention consisting of two training modules for medical professionals. Module 1 is delivered over 2-3 days, takes place in the hospital, and consists of high-fidelity, low-tech simulations. The curriculum employs elements of the Team STEPPS program to strengthen teamwork and leadership skills, and the use of effective communication techniques. The activities and simulations have clear objectives and use evidenced-based medical concepts. Module 2, the follow-up training, uses the same teaching methodology as Module 1 to reinforce teamwork, communication, and emergency response skills, and incorporates new topics such as preeclampsia /eclampsia, shoulder dystocia and pelvic presentation. |
| Measure | Description | Time Frame |
|---|---|---|
| Perinatal mortality | Assess perinatal mortality over the 12 month period following the training intervention | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Death rate from obstetric hemorrhage | Number of deaths from obstetric hemorrhage/total number of obstetric hemorrhages | 12 months |
| Death rate from preeclampsia/eclampsia | Number of deaths from preeclampsia/eclampsia / totaly number of preeclampsia/eclampsia cases |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Dilys M Walker, MD | National Institute of Public Health Mexico | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29902983 | Derived | Fritz J, Lamadrid-Figueroa H, Angeles G, Montoya A, Walker D. Health providers pass knowledge and abilities acquired by training in obstetric emergencies to their peers: the average treatment on the treated effect of PRONTO on delivery attendance in Mexico. BMC Pregnancy Childbirth. 2018 Jun 15;18(1):232. doi: 10.1186/s12884-018-1872-4. | |
| 28319122 |
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| ID | Term |
|---|---|
| D063130 | Maternal Death |
| D066087 | Perinatal Death |
| ID | Term |
|---|---|
| D063129 | Parental Death |
| D003643 | Death |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Secretary for Women, Mexico state |
| UNKNOWN |
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|
| 12 months |
| Serious maternal complications | Assess the number of serious obstetric complications over 12 months following training intervention | 12 months |
| Fritz J, Walker DM, Cohen S, Angeles G, Lamadrid-Figueroa H. Can a simulation-based training program impact the use of evidence based routine practices at birth? Results of a hospital-based cluster randomized trial in Mexico. PLoS One. 2017 Mar 20;12(3):e0172623. doi: 10.1371/journal.pone.0172623. eCollection 2017. |
| 25409895 | Derived | Walker D, Cohen S, Fritz J, Olvera M, Lamadrid-Figueroa H, Cowan JG, Hernandez DG, Dettinger JC, Fahey JO. Team training in obstetric and neonatal emergencies using highly realistic simulation in Mexico: impact on process indicators. BMC Pregnancy Childbirth. 2014 Nov 20;14:367. doi: 10.1186/s12884-014-0367-1. |
| D011248 |
| Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |