See related article by Varghese.
In this issue of GHSP, Varghese and colleagues present the results of a set of "skills and drills" activities aimed at improving maternal and newborn emergency care in a high-mortality setting in Karnataka, India.1 The Argentine Institute for Clinical Effectiveness and Health Policy with funding from the Maternal Health Task Force provided catalytic training and orientation activities over 2.5 days to a core group of coordinators. These coordinators formed a regional team composed of 8 nurses and 20 physicians from medical colleges in Karnataka. They instituted the skills and drills practice-improvement activities in 4 intervention facilities with mainly local human and material resources. The activities consisted of a 2-day skills course at the study facilities followed by visits to the facilities every 2 months over a 12-month period to carry out drills and supportive supervision activities.
Practitioners deemed the skills and drills intervention feasible and acceptable, and there was a modest increase in provider knowledge and skills. But the intervention appeared not to have achieved its desired results in improvements in clinical practice, either in the identification of cases in need of emergency intervention or in improved response to identified emergencies. This may be attributable to continued poor reporting, but since that also was a focus of the intervention, this lack of improvement in documentation is itself instructive.
PREVIOUS RELATED WORK
Teamwork and emergency preparedness have been shown to be key determinants …