CIESAS – Evaluating the ALSO program

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The following is part of a series of project updates from the Centro de Investigaciones y Estudios Superiores en Antropologia (CIESAS). MHTF is supporting their project, Evaluation of ALSO Program. More information on MHTF supported projects can be found here.

In the last quarter (February- April 2011), CIESAS and its partner Population Council, continued with their evaluation on the impact of the ALSO program in the main public hospital of Oaxaca City, Mexico. 105 obstetric emergencies (71 preeclampsia/eclampsia and 34 intra-partum/post-partum haemorrhage) were observed during the morning and night shifts at the hospital up to mid-May. The volume of observations has increased although at a slower pace than initially thought, in part because Ob/Gyns at the hospital take preventive measures well before the full OEm arises. For instance, it is common to use magnesium sulphate in patients with mild elevations of blood pressure before reaching the severe preeclampsia level.

At the same time, our four observers have carried out observations of the management of hospital births, paying particular attention to the active management of the third stage of labor. Up to mid-May, 179 hospital births’ checklists were filled, observing some crucial management aspects that ALSO teaches in its courses to attending OB/Gyns. We have also been paying close attention to the hospital context, as of relevant events, actions, conversations or other non verbal interactions, that have to do with the actual unfolding of hospital’s and hospital personnel’s day to day activities, including the actual interaction that medical, nursing and administrative personnel establish with our observers and with women patients day after day during their stay at the hospital. In general, observers have blended in well with the hospital and have helped us to understand many hospital dynamics and actual management of obstetric care.

Recently, we have begun reviewing pre-ALSO vs. post-ALSO EmOC medical charts at the Valdivieso Hospital; the reviewing process will continue up to mid-July.