Module 1: Clinical Officers as Advanced Leaders
Module 1 took place over 5 days in November and December 2011 and included the topics and discussions below:
- Introduction Clinical officers as advanced leaders
- Epidemiology Traditional birth attendants; rationale for change; current dadta on place of delivery; major causes of maternal death and neonatal death
- Antenatal care
- Neonatal resuscitation What about the baby? What are the major causes of neonatal death and disability in Malawi?
- Serious maternal and neonatal infections in the local context Appropriate antibiotics on local inventory? What to do when these are not available
- Collecting the data on HIV infection and acting on it Checking HIV status of pregnant women; offering counselling and contact tracing
- The implications of being HIV postive for preventing puerperal sepsis
- Management of sick neonates Signs and symptoms; appropriate interventions; local settings
- Managing bleeding and blood loss in PPH
- Are we giving women a good start? Detecting, preventing and correcting anaemia; steps to enhance current practice
- Life support in haemorrhage and fluid loss Optimal support for the haemorrhaging patient at clinics, during transfer and on reception at district hospitals; fluid balance considerations
- Blood transfusion: have we got enough? If not, why not? Evidence from the most recent inventory; current guidelines for storage and administration of blood; experience of supporting women with PPH; current guidelines on blood donation
- Bleeding in caesarean section
- Abortion
- Effective intervention post-abortion
- Managing hypertension In pregnancy and antenatal care - BP checks of pregnant women; availability of sphygmomanometers; health eduction for reporting signs of pre-eclampsia; time of transfer for raised BP
- The eclamptic patient and management Local and international practices
- Magnesium sulphate - evidence of effectiveness Is it administered early enough - if not, why not? Local guidelines on use of magnesium sulphate
- Puerperal sepsis
- Active monitoring Is the partogram being used?
- Place of delivery Where do women deliver and why? Relevance of place of delivery to incidence of infection and to PPH
- Right place, right time? Pathways of care: transfer between healthcare localities - low birthweight and perinatal loss: what is the evidence? Should there be more guideance on place of care? Transfers in utero, time intervals for decision-making, transport, reception, operative intervention