Implementation of a Maternal Health Curriculum and Distance

Implementation of a Maternal Health
Curriculum and Distance Learning
Program in South Sudan
Cholene Espinoza, MD
PGY-1
St. George’s University
Ministry of Health South Sudan
South Sudan
St. George’s University
Ministry of Health South Sudan
The need is great.
St. George’s University
Ministry of Health South Sudan
41 physicians serving 11.5 million
St. George’s University
Ministry of Health South Sudan
97% of deliveries are by birth attendants.
3%
97%
Birth attendants
Physicians
St. George’s University
Ministry of Health South Sudan
1% of deliveries are by Cesarean.
1%
99%
Vaginal
Cesarean
St. George’s University
Ministry of Health South Sudan
1 in 7 women will die in childbirth.
St. George’s University
Ministry of Health South Sudan
The need is great.
• There are no post-graduate training programs
in Obstetrics and Gynecology, so that MBBSqualified doctors remain especially
underprepared in maternal and neonatal care.
• This deficit extends to training of nurses and
midwives as well. Currently nursing/midwifery
education has been suspended despite
enormous demand.
St. George’s University
Ministry of Health South Sudan
“If the country of South Sudan were to attempt
to train medical professionals in a traditional
model with onsite staffing, it would take over 60
years given the number of qualified people now
available to train doctors and nurses.
Technology, however, can be leveraged to
accelerate this process.”
Dr. Riek Gai Kok, S. Sudan Minister of Health
St. George’s University
Ministry of Health South Sudan
Aim
Our aim was to provide a curriculum
in maternal health for Juba University
Bachelor of Medicine, Bachelor of
Surgery (MBBS) candidates.
St. George’s University
Ministry of Health South Sudan
METHODS
St. George’s University
Ministry of Health South Sudan
Methods
• Identification of critical topics pertinent to
maternal health in South Sudan.
• Distance learning intervention development.
– Funding
– Technology delivery
St. George’s University
Ministry of Health South Sudan
RESULTS
St. George’s University
Ministry of Health South Sudan
Results
Topic
Identification
• Physiology pertinent to
maternal health.
• Drawn from St. George’s
University’s core lecture
series (previously
recorded).
Distance Learning Intervention
• Funding secured through a
nonprofit organization
• Tablets obtained and loaded
with core lecture series
St. George’s University
Ministry of Health South Sudan
84 tablets secured and prepared.
St. George’s University
Ministry of Health South Sudan
47 pre-recorded lectures loaded.
St. George’s University
Ministry of Health South Sudan
Lectures + Facilitated small group
St. George’s University
Ministry of Health South Sudan
Results
• Written tests (n = 187) following the
intervention showed substantial knowledge
acquisition.
– Mean score = 63%; SD +/- 12.8%
• Qualitative debriefing sessions revealed
unanimously positive responses from the students
and instructors.
St. George’s University
Ministry of Health South Sudan
Physiology outperformed Anatomy.
100%
90%
80%
70%
60%
Year 2
Year 3
50%
40%
30%
20%
10%
0%
Anatomy
Physiology
St. George’s University
Biochemistry
Ministry of Health South Sudan
Physiology results were similar to Biochemistry.
100%
90%
80%
70%
60%
Year 2
Year 3
50%
40%
30%
20%
10%
0%
Anatomy
Physiology
St. George’s University
Biochemistry
Ministry of Health South Sudan
Conclusion
• The use of pre-recorded lectures on tablets
and small group facilitation resulted in
successful implementation of a distancelearning program for maternal health in an
underserved country.
St. George’s University
Ministry of Health South Sudan
The need remains great.
• Future Directions
– Logistics
• Asset inventory
• Device capacity (RACHEL utilization)
• English as a Second Language
– Content
• Shift focus to maternal health curriculum
• Content development
St. George’s University
Ministry of Health South Sudan
We need you!
St. George’s University
Ministry of Health South Sudan
Gratitude
• Co authors: Dr. Melissa Wong, Dr. Mayen
Achiek, Dr. Mark Clunes, Dr. Chatchai Kokar,
Zach Silverstein
• G.E.M.S. Development Foundation
• Cedars Sinai Medical Center Department of
Obstetrics and Gynecology
• St. George’s University School of Medicine
• Dr. Riek Gai Kok, Minister of Health, South
Sudan
• Juba College of Nursing and Midwifery
• Juba Teaching Hospital, South Sudan
• Honorable Tong Deng, Minister of Health
NBGS
• The medical students of Juba University
St. George’s University
Ministry of Health South Sudan
Thank You (in advance!)
St. George’s University
Ministry of Health South Sudan
Questions
St. George’s University
Ministry of Health South Sudan