In 2019-2020 we saw that it is possible to implement regular low cost training in a low resource setting and the first results also show an improvement of knowledge and skills. Simulation training focusses mostly on individual learning, but to really improve quality of care we need to improve the whole system. Human makes mistakes, we are no angels. Worldwide most harm in health care is due to human factors. Usually harm done to a patient cannot be blamed on one person, but is an effect of a failing system. Multiple consecutively small human mistakes cause one big error. In Nyangao we are facing a lot of challenges due to low resources, this causes even more human error. As we cannot create a lot of money all at once we need to look at things from another perspective.
In 2020-2021 we will introduce crew resource management (CRM) training during the simulation training. Is short CRM means: looking at what you do have (instead of what you do not have) and how you can use this more effectively. The goal of CRM is to coordinate, utilize and apply all available resources (including people) as optimal as possible to improve safety and outcomes. Crew resource management is never described as an intervention in a low resource setting. This study will see if crew resource management also has benefits in a low resource setting and if it is possible to implement regular training in the system
Pregnancy outcomes between users and non-users of maternity waining home at Nyangao Hospital in rural southern Tanzania: A retrospective cohort study
Maternity waiting home was associated with fewer admissions to NICU and utilized more by women whose permanent residence were more distant from the hospital. Women with risk pregnancy should be advised to stay near the hospital in their last weeks of delivery to reduce delays in receiving EmONC when obstetric emergency occurs.