Skip to main content

Main menu

  • Content
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • Special Collections
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Tips for Writing About Programs in GHSP
      • Local Voices Webinar
      • Connecting Creators and Users of Knowledge
    • Submit Manuscript
    • Publish a Supplement
    • Promote Your Article
    • Resources for Writing Journal Articles
  • About
    • About GHSP
    • Editorial Team
    • Advisory Board
    • FAQs
    • Instructions for Reviewers

User menu

  • My Alerts

Search

  • Advanced search
Global Health: Science and Practice
  • My Alerts

Global Health: Science and Practice

Dedicated to what works in global health programs

Advanced Search

  • Content
    • Current Issue
    • Advance Access
    • Archive
    • Supplements
    • Special Collections
    • Topic Collections
  • For Authors
    • Instructions for Authors
    • Tips for Writing About Programs in GHSP
    • Submit Manuscript
    • Publish a Supplement
    • Promote Your Article
    • Resources for Writing Journal Articles
  • About
    • About GHSP
    • Editorial Team
    • Advisory Board
    • FAQs
    • Instructions for Reviewers
  • Alerts
  • Find GHSP on LinkedIn
  • Visit GHSP on Facebook
  • RSS
ORIGINAL ARTICLE
Open Access

Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study

Beena Varghese, Jayanna Krishnamurthy, Blaze Correia, Ruchika Panigrahi, Maryann Washington, Vinotha Ponnuswamy and Prem Mony
Global Health: Science and Practice December 2016, 4(4):582-593; https://doi.org/10.9745/GHSP-D-16-00143
Beena Varghese
aPublic Health Foundation of India, Gurugram, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: beena.varghese@phfi.org
Jayanna Krishnamurthy
bKarnataka Health Promotion Trust, Bangalore, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Blaze Correia
cSt. Johns Research Institute, Bangalore, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ruchika Panigrahi
bKarnataka Health Promotion Trust, Bangalore, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maryann Washington
cSt. Johns Research Institute, Bangalore, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vinotha Ponnuswamy
cSt. Johns Research Institute, Bangalore, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Prem Mony
cSt. Johns Research Institute, Bangalore, India.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
PreviousNext
  • Article
  • Figures & Tables
  • Info & Metrics
  • Comments
  • PDF
Loading
Submit a Comment to This Article
Compose eLetter

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.

Vertical Tabs

Jump to comment:

  • Possible reasons for limited effectiveness
    Helen A Allott
    Published on: 20 December 2016
  • Published on: (20 December 2016)
    Page navigation anchor for Possible reasons for limited effectiveness
    Possible reasons for limited effectiveness
    • Helen A Allott, Senior Technical Officer
    • Other Contributors:

    We read with interest the paper by Varghese et al 1 regarding the limited effectiveness of a skills and drills intervention to improve Emergency Obstetric and Newborn Care and the editorial by Ricca2.

    Ricca has discussed some possible reasons as to why the intervention had limited effect when it came to improved diagnosis and management of maternal and newborn complications, including systems weaknesses, provide...

    Show More

    We read with interest the paper by Varghese et al 1 regarding the limited effectiveness of a skills and drills intervention to improve Emergency Obstetric and Newborn Care and the editorial by Ricca2.

    Ricca has discussed some possible reasons as to why the intervention had limited effect when it came to improved diagnosis and management of maternal and newborn complications, including systems weaknesses, provider motivation and behaviour and barriers to teamwork in the workplace.

    We would like to draw attention to a further possible reason for the limited effectiveness in translating the training into demonstrable improvements in clinical care. Whilst there were statistically significant improvements in both knowledge and skills, as assessed by pre and post intervention knowledge and skills assessments, it may be that these improvements, albeit of significance, still did not cross a threshold of improvement necessary to make a real difference in clinical practice. It could be argued, for example, that a score of 56% in understanding how to recognise and act in an obstetric emergency, is simply still not enough.

    We would, therefore, suggest that prior to implementing any further such intervention, both the content and mode of delivery of the training intervention be re-explored with a view to gaining an understanding as to why it was that participants' scores did not reach a higher level, and implementing appropriate changes in the training in order to achieve a greater demonstrable level of knowledge and skills improvement such as may be more likely to impact on clinical practice.

    In our experience in the multi country Making it Happen programme3, setting up of skills training rooms4,5, training of healthcare facility- based mentors and supervisors were successful approaches in bringing about change in behaviour and practice after training.

    Finally, evaluating the effectiveness of training programmes is the final step of an effective training programme design but in order to improve the strength of the results, attention must be paid to more robust designs beyond pre and post training assessments. Having a matched comparison group with outcome indictors linked to the training intervention will minimise bias associated with the results. The stepped wedge research design6 will allow all clusters to receive the intervention at various times but being part of the control group at some point. This design is better suited for when it is known that an intervention has benefits, and it is therefore unethical to withhold the intervention from other groups.

    Helen Allott, Helen Smith, Terry Kana, Mselenge Mdegela, Sarah Bar- Zeev and Charles Ameh Centre for Maternal and Newborn Health Liverpool School of Tropical Medicine

    1. Varghese B, Krishnamurthy J, Correia B, Panigrahi R, Washington M, Ponnuswary V, et al. Limited effectiveness of a Skills and Drills intervention to improve Emergency Obstetric and Newborn Care in Karnataka, India: A proof-of-concept study. Glob Health Sci Pract. December 19, 2016, doi:10.9745/GHSP-D-16-00272

    2. Ricca J. Limits of "Skills and Drills" Intervetions to Improving Obstetric and Newborn Emergency Response: What More DO We Need to Learn? Glob Health Sci Pract. Dec 19, 2016, doi:10.9745/GHSP-D-16-00272

    3. Ameh CA and van den Broek N. Making it Happen:Training health-care providers in emergency obstetric and newborn care. Best Practice & Research Clinical Obstetrics and Gynaecology. 2015; 29:1077-1091

    4. Utz B, Kana T and van den Broek N. Practical aspects of setting up obstetrics skills laboratories -A literature review and proposed model. Midwifery. 2015; 31: 400-408

    5. Raven J, Utz B, Roberts D and van den Broek N. The @Making it Happen@ programme in India and Bangladesh. BJOG. 2011.Sept:118 Suppl 2:100 -103

    6. Hemming K, Haines TP, Chilton PJ, Girling AJ and Lilford RJ. The stepped wedge cluster randomised trial: rationale, design, analysis and reporting. BMJ. 2015; 350: h391

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.
PreviousNext
Back to top

In this issue

Global Health: Science and Practice: 4 (4)
Global Health: Science and Practice
Vol. 4, No. 4
December 23, 2016
  • Table of Contents
  • About the Cover
  • Index by Author
  • Complete Issue (PDF)
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about Global Health: Science and Practice.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study
(Your Name) has forwarded a page to you from Global Health: Science and Practice
(Your Name) thought you would like to see this page from the Global Health: Science and Practice web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study
Beena Varghese, Jayanna Krishnamurthy, Blaze Correia, Ruchika Panigrahi, Maryann Washington, Vinotha Ponnuswamy, Prem Mony
Global Health: Science and Practice Dec 2016, 4 (4) 582-593; DOI: 10.9745/GHSP-D-16-00143

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care in Karnataka, India: A Proof-of-Concept Study
Beena Varghese, Jayanna Krishnamurthy, Blaze Correia, Ruchika Panigrahi, Maryann Washington, Vinotha Ponnuswamy, Prem Mony
Global Health: Science and Practice Dec 2016, 4 (4) 582-593; DOI: 10.9745/GHSP-D-16-00143
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Statistics from Altmetric.com

Jump to section

  • Article
    • ABSTRACT
    • BACKGROUND
    • METHODOLOGY
    • RESULTS
    • DISCUSSION
    • CONCLUSION
    • Acknowledgments
    • Notes
    • REFERENCES
  • Figures & Tables
  • Info & Metrics
  • Comments
  • PDF

Related Articles

  • Limits of “Skills And Drills” Interventions to Improving Obstetric and Newborn Emergency Response: What More Do We Need to Learn?
  • Possible Reasons for Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care
  • PubMed
  • Google Scholar

Cited By...

  • Effects of emergency obstetric care training on maternal and perinatal outcomes: a stepped wedge cluster randomised trial in South Africa
  • Competence of healthcare professionals in diagnosing and managing obstetric complications and conducting neonatal care: a clinical vignette-based assessment in district and subdistrict hospitals in northern Bangladesh
  • Possible Reasons for Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care
  • Limits of "Skills And Drills" Interventions to Improving Obstetric and Newborn Emergency Response: What More Do We Need to Learn?
  • Google Scholar

More in this TOC Section

  • People that Deliver Theory of Change for Building Human Resources for Supply Chain Management: Applications in sub-Saharan Africa and Southeast Asia
  • Exploring the Role of Gender in the Public Health Supply Chain Workforce in Low- and Middle-Income Countries
  • Applying a Theory of Change for Human Resources Development in Public Health Supply Chains in Rwanda
Show more ORIGINAL ARTICLE

Similar Articles

Subjects

  • Cross-Cutting Topics
    • Health Workers
  • Health Topics
    • Maternal, Newborn, and Child Health
Johns Hopkins Center for Communication Programs

Follow Us On

  • LinkedIn
  • Facebook
  • RSS

Articles

  • Current Issue
  • Advance Access Articles
  • Past Issues
  • Topic Collections
  • Most Read Articles
  • Supplements

More Information

  • Submit a Paper
  • Instructions for Authors
  • Instructions for Reviewers

About

  • About GHSP
  • Advisory Board
  • FAQs
  • Privacy Policy
  • Contact Us

© 2025 Creative Commons Attribution 4.0 International License. ISSN: 2169-575X

Powered by HighWire