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.

Through the period May-July 2011, CIESAS and its partner Population Council have slowly begun to wrap up the fieldwork phase of the evaluation of the ALSO training program on the management of severe preeclampsia/eclampsia and intra- and post-partum hemorrhage in the main public hospital of Oaxaca City, Mexico. Major fieldwork components include:

• on-site observations of the management of obstetric emergencies and other key ALSO elements during normal deliveries– such as the active management of the third stage of labor–,by certified and non-certified Ob/Gyns in ALSO;
• the review of medical charts of patients with obstetric emergencies in order to compare their management at the hospital in a pre-ALSO (January-July 2009) stage versus a post-ALSO (February-August 2010) stage;
• in-depth interviews with certified and uncertified Ob/Gyns in ALSO; and
• the application of a questionnaire on “enabling or hindering environmental factors” at the hospital.

By the end of July, our four observers finalized the observations of obstetric emergencies and normal deliveries. Final numbers of observed EmOC cases are: preeclampsia/eclampsia=85, and hemorrhage= 41. They also observed 264 normal deliveries. We entered these data in our databases and will start analysis soon.
Our research team has nearly concluded the review of medical charts of obstetric patients. While we had no problem in identifying enough charts for severe preeclampsia/eclampsia cases (N=85), we faced a major challenge in singling out medical charts for hemorrhage cases. So far, we have found 41 cases from the post-ALSO period and we are in the process of filtering out obstetric medical charts form the pre-ALSO period to single out hemorrhage cases.

 

Observers’ fieldwork journals, upcoming in-depth interviews with Ob/Gyns, and the questionnaire on enabling or hindering factors in the hospital environment will provide the relevant context information for our evaluation.