WHO recently launched a new training course on infection prevention and control for maternal and neonatal care. The course is aimed at staff working in maternal and neonatal wards, specifically, antenatal care outpatient services, maternal and neonatal inpatient services, and neonatal intensive care services.
The course is divided into 6 sessions. The first session covers the essential knowledge of standard precautions required for good infection prevention and control. The other five sessions develop this knowledge and apply it clinically to common situations in antenatal care, labour, childbirth and neonatal care. Currently the first three sessions are available.
Module 1: Introduction to Infection prevention and control
Module 2: Care of the pregnant woman in antenatal clinic
Module 3: Admission of the pregnant woman, labour and uncomplicated childbirth
Module 4: When interventions are required in labour (in production)
Module 5: Caesarean section (in production)
Module 6: Special neonatal circumstances (in production)
On World Sepsis Day we renew our commitment to raise awareness of sepsis and increase efforts to reduce the worldwide burden of this life-threatening condition. Latest estimates pose that about 11 million people each year because of sepsis and evidence from GLOSS has shown the significant impact sepsis has on maternal mortality and morbidity. New evidence suggests that about one third of all births from women with infection were severe perinatal outcomes (neonatal near-miss or perinatal death).
Please help us amplify the messages around maternal sepsis and share the GLOSS-related publications widely:
A new paper on an analysis of GLOSS participating facilities was published in Lancet Global Health. It showed that availability of resources and services necessary to prevent, identify, and manage maternal infections in facilities that participated in GLOSS did not always result in better maternal outcomes. In fact, it showed that individual women’s characteristics known to be associated with poor maternal outcomes, such as pre-existing conditions, are more probable predictors of severe outcomes than characteristics of a health facility (e.g. medical supplies and equipment).
Remember to visit our resources page for other resources to use in your facilities.
Background: Infections are among the leading causes of maternal mortality and morbidity. The Global Maternal Sepsis and Neonatal Initiative, launched in 2016 by WHO and partners, sought to reduce the burden of maternal infections and sepsis and was the basis upon which the Global Maternal Sepsis Study (GLOSS) was implemented in 2017. In this Article, we aimed to describe the availability of facility resources and services and to analyse their association with maternal outcomes.
Methods: GLOSS was a facility-based, prospective, 1-week inception cohort study implemented in 713 health-care facilities in 52 countries and included 2850 hospitalised pregnant or recently pregnant women with suspected or confirmed infections. All women admitted for or in hospital with suspected or confirmed infections during pregnancy, childbirth, post partum, or post abortion at any of the participating facilities between Nov 28 and Dec 4 were eligible for inclusion. In this study, we included all GLOSS participating facilities that collected facility-level data (446 of 713 facilities). We used data obtained from individual forms completed for each enrolled woman and their newborn babies by trained researchers who checked the medical records and from facility forms completed by hospital administrators for each participating facility. We described facilities according to country income level, compliance with providing core clinical interventions and services according to women’s needs and reported availability, and severity of infection-related maternal outcomes. We used a logistic multilevel mixed model for assessing the association between facility characteristics and infection-related maternal outcomes.
Findings: We included 446 facilities from 46 countries that enrolled 2560 women. We found a high availability of most services and resources needed for obstetric care and infection prevention. We found increased odds for severe maternal outcomes among women enrolled during the post-partum or post-abortion period from facilities located in low-income countries (adjusted odds ratio 1·84 [95% CI 1·05–3·22]) and among women enrolled during pregnancy or childbirth from non-urban facilities (adjusted odds ratio 2·44 [1·02–5·85]). Despite compliance being high overall, it was low with regards to measuring respiratory rate (85 [24%] of 355 facilities) and measuring pulse oximetry (184 [57%] of 325 facilities).
Interpretation: While health-care facilities caring for pregnant and recently pregnant women with suspected or confirmed infections have access to a wide range of resources and interventions, worse maternal outcomes are seen among recently pregnant women located in low-income countries than among those in higher-income countries; this trend is similar for pregnant women. Compliance with cost-effective clinical practices and timely care of women with particular individual characteristics can potentially improve infection-related maternal outcomes.
And on the year of the nurse and midwife the focus is on them. We are joining WHO in calling all health workers to join hands in celebrating nurses and midwives in the work that they do to keep our women and newborns safe by preventing health care-associated infections.
Find all the materials for this year’s campaign here.
For 2019, the “SAVE LIVES: Clean Your Hands” campaign led by WHO calls on everyone to be inspired by the global movement to achieve universal health coverage (UHC) in promoting hand hygiene. If you haven’t signed up for the campaign already, please do so here. You can find the entire campaign toolkit following this link.
The Infection Prevention and Control (IPC) unit at WHO is coordinating a global survey on the current level of progress in IPC programmes and hand hygiene activities in healthcare facilities in the context of the annual WHO hand hygiene campaign –scheduled for 5 May 2019.
The survey has two levels, involving the completion of two tools at the facility:
On 5 and 6 September 2018, the Global Sepsis Alliance held their Second World Sepsis Congress. Every session was recorded and is now available as a YouTube video or podcast. There was an entire session on the challenges of maternal and neonatal sepsis.
Please use the following link to see the YouTube video of this session and this link to access the podcast on this and other sessions.
For more information on the World Sepsis Congress, please visit their website here.
Over the course of 17 sessions, more than 100 speakers from 30 countries will discuss all aspects of sepsis and its wide-ranging consequences. There will be sessions on prevention of infections and sepsis, two session on maternal and pediatric sepsis, and one session on awareness and education.
The session on maternal sepsis is scheduled for Thursday 6 September starting at 14:30h UTC. Please refer to the programme for more information.
Our GLOSS colleagues in the Netherlands just co-authored a new publication on sepsis-related maternal mortality in Suriname. Through a nation-wide survey they identified and surveyed all maternal deaths. Forty-five percent of all the maternal deaths identified were sepsis-related; substandard care factors were identified for monitoring, diagnosing, and treating women.
Please read the full article here: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0200281