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. 2021 Apr 26;21(1):384.
doi: 10.1186/s12913-021-06385-5.

Key components influencing the sustainability of a multi-professional obstetric emergencies training programme in a middle-income setting: a qualitative study

Kiren Ghag  1   2 , Rachna Bahl  3 , Cathy Winter  4 , Mary Lynch  4 , Nayda Bautista  5 , Rogelio Ilagan  5 , Matthew Ellis  6 , Isabel de Salis  6 , Timothy J Draycott  4
Affiliations

Key components influencing the sustainability of a multi-professional obstetric emergencies training programme in a middle-income setting: a qualitative study

Kiren Ghag et al. BMC Health Serv Res. .

Abstract

Background: Multi-professional obstetric emergencies training is one promising strategy to improve maternity care. Sustaining training programmes following successful implementation remains a challenge. Understanding, and incorporating, key components within the implementation process can embed interventions within healthcare systems, thereby enhancing sustainability. This study aimed to identify key components influencing sustainability of PRactical Obstetric Multi-Professional Training (PROMPT) in the Philippines, a middle-income setting.

Methods: Three hospitals were purposively sampled to represent private, public and teaching hospital settings. Two focus groups, one comprising local trainers and one comprising training participants, were conducted in each hospital using a semi-structured topic guide. Focus groups were audio recorded. Data were analysed using thematic analysis. Three researchers independently coded transcripts to ensure interpretation consistency.

Results: Three themes influencing sustainability were identified; attributes of local champions, multi-level organisational involvement and addressing organisational challenges.

Conclusions: These themes, including potential barriers to sustainability, should be considered when designing and implementing training programmes in middle-income settings. When 'scaling-up', local clinicians should be actively involved in selecting influential implementation champions to identify challenges and strategies specific to their organisation. Network meetings could enable shared learning and sustain enthusiasm amongst local training teams. Policy makers should be engaged early, to support funding and align training with national priorities.

Keywords: Implementation; Middle-income setting; Obstetric emergencies, multi-professional training; Sustainability.

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Conflict of interest statement

TD is a Trustee, and KG and ML are Members, of the PROMPT Maternity Foundation, the charity that produces the PROMPT training package. They do not receive any financial reward for their association with this charity. CW is a Member of, and employed by, the PROMPT Maternity Foundation. NB is employed by Project HOPE, the organisation that coordinated the local implementation of the Philippines PROMPT Project and provided funding for the study. RI was an employee of Project HOPE during the time of the study.

Figures

Fig. 1
Fig. 1
Key themes and sub-themes influencing sustainability
Fig. 2
Fig. 2
Quotations contributing to the formation of Theme 1: Attributes of local champions
Fig. 3
Fig. 3
Quotations contributing to the formation of Theme 2: Multi-level organisational involvement
Fig. 4
Fig. 4
Quotations contributing to the formation of Theme 3: Addressing organisational challenges
See this image and copyright information in PMC

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