Article type
Year
Abstract
Background: SEA-ORCHID is a five-year collaborative project (2004-2008) between Australia and four countries in South East Asia. Using an interrupted time series design, the project aims to address whether the health of mothers and babies in Thailand, Malaysia, the Philippines and Indonesia can be improved by increasing the capacity for research synthesis and implementation of effective interventions. In Thailand, a provincial (Kalasin), regional (Khon Kaen) and university hospital (Srinagarind) are participating in the project.
Objectives: To assess whether current management of specific pregnancy and childbirth related practices follows best practice recommendations in three hospitals in Thailand.
Methods: During May-September 2005, a trained nurse at each hospital prospectively reviewed the case reports of 1000 women and extracted data on a range of maternal and infant outcomes. Frequencies and percentages were used to present the practices and health outcomes.
Results: For several practices, such as suturing of the perineum, oxytocin during third stage, early cord clamping and immunization against Hepatitis B, recommendations were followed in over 90% of cases across all hospitals. Rates for ineffective practices, such as shaving of the perineum and use of enema, varied widely among hospitals: 98.3 %, 43.0 % and 79.1 %, and 60.6%, 0.7 % and 29.0% respectively for Kalasin, Khon Kaen and Srinagarind. We identified several practices for which adherence to recommendations could be improved: use of antenatal corticosteroids, support during labour, external cephalic version for breech presentation, and selective use of episiotomy. Two per cent of babies were either stillborn or died after birth. There were no maternal deaths. Further comparative data will be presented at the Colloquium.
Conclusions: The baseline data have highlighted several areas where more effective implementation of evidence is required. Interventions to improve practice are currently being planned at each hospital and will address local barriers to the uptake of evidence. SEA-Optimising Reproductive and Child Health Outcomes in Developing Countries (ORCHID) is jointly funded by the Wellcome Trust, UK and the National Health and Medical Research Council, Australia. www.seaorchid.org.
Objectives: To assess whether current management of specific pregnancy and childbirth related practices follows best practice recommendations in three hospitals in Thailand.
Methods: During May-September 2005, a trained nurse at each hospital prospectively reviewed the case reports of 1000 women and extracted data on a range of maternal and infant outcomes. Frequencies and percentages were used to present the practices and health outcomes.
Results: For several practices, such as suturing of the perineum, oxytocin during third stage, early cord clamping and immunization against Hepatitis B, recommendations were followed in over 90% of cases across all hospitals. Rates for ineffective practices, such as shaving of the perineum and use of enema, varied widely among hospitals: 98.3 %, 43.0 % and 79.1 %, and 60.6%, 0.7 % and 29.0% respectively for Kalasin, Khon Kaen and Srinagarind. We identified several practices for which adherence to recommendations could be improved: use of antenatal corticosteroids, support during labour, external cephalic version for breech presentation, and selective use of episiotomy. Two per cent of babies were either stillborn or died after birth. There were no maternal deaths. Further comparative data will be presented at the Colloquium.
Conclusions: The baseline data have highlighted several areas where more effective implementation of evidence is required. Interventions to improve practice are currently being planned at each hospital and will address local barriers to the uptake of evidence. SEA-Optimising Reproductive and Child Health Outcomes in Developing Countries (ORCHID) is jointly funded by the Wellcome Trust, UK and the National Health and Medical Research Council, Australia. www.seaorchid.org.