Web-Based Development of Standard Operating Procedures and Midwifery Trainings at Ugandan Birth Clinic in the Framework of Implementing a Quality Improvement System for the MEWU-Midwife Exchange with Uganda.

Abstract

Introduction: High maternal and newborn mortality rates in Sub-Saharan Africa indicate the need for global action interventions. Thus, the clinic cooperation midwife exchange with Uganda (MEWU) between Hannover Medical School and Mutolere Hospital, Uganda, was founded. This study, as the first intervention within the MEWU framework, explored whether a web-based approach is suitable for developing, training, and establishing standard operating procedures (SOPs) at Mutolere Hospital. We focused on assessing midwives' confidence in midwifery core competencies.

Methods: The study was conducted in a prospective, non-controlled intervention design. As a quality improvement tool, the Plan, Do, Check, Act cycle was implemented. SOPs for standard obstetric care were developed and trained in online meetings. Qualitative and quantitative data were collected through a questionnaire completed pre- and post-intervention by participating midwives, evaluations, minutes and video recordings of each case training, and annual analytical reports from Mutolere Hospital containing morbidity and mortality data.

Results: The online intervention was successfully implemented. Nine SOPs on basic obstetric care were developed, trained in online case training, and integrated into clinical practice at Mutolere Hospital. An increase in midwives' confidence regarding all surveyed core competencies was observed. There were no significant changes in the hospital's morbidity and mortality rates. The quality management system was implemented to optimize the follow-up projects further.

Conclusion: This pilot study shows the potential of web-based interventions as a quality improvement tool in developing countries. The developed SOPs and video database are being used in subsequent studies and extended to further health centers in the Kisoro region.