Achievement of Elective Cesarean Following Surgical Repair of Female Genital Fistula in Uganda

Childbearing following recovery from female genital fistula in lower-resource settings is important for some women. Cesarean birth is recommended by fistula caregivers to reduce adverse outcomes, yet is inconsistently achieved. Understanding factors influencing post-repair elective cesarean may inform clinical and counseling interventions. We sought to understand perinatal experiences and care-seeking among Ugandan women who previously underwent fistula repair.

Improving Quality and Access to Safe Cesarean Section: Comprehensive Emergency Obstetric and Newborn Care (CEmONC) Mentorship and Onsite Simulation-Based Training in Developing Regional States of Ethiopia 

The World Health Organization estimates that around 295,000 women die due to complications of pregnancy and childbirth. Cesarean section (CS) is an essential part of comprehensive emergency obstetric and newborn care (CEmONC) and a life-saving intervention for women and newborns when it is done safely, timely, and with absolute indication. Access to safe CS is still suboptimal in low- and middle-income countries including Ethiopia. Nonavailability of competent providers to provide safe CS is a major barrier. The Ethiopian Society of Obstetricians and Gynecologists (ESOG) collaborated with partners and the Ministry of Health to improve CEmONC services in selected hospitals.

Post-discharge Tracking of Surgical Site Infections among Caesarean Section Clients in Makueni County, Kenya 

Most surgical site infections (SSIs) following cesarean section (CS) occur following discharge of the mother from the hospital. In Kenya, poor follow-up of the client after she leaves the facility, lack of self-care awareness of post-CS women, and delayed care seeking are major gaps in improving detection and timely management of SSIs, as well as in providing accurate estimation of SSI rates. The Johnson and Johnson-funded Obstetric Safe Surgery (OSS) project in Makueni County, Kenya, aimed to strengthen community-level follow-up of mothers and newborns at days 7 and 30 following CS.

A Multidisciplinary Team-Based Approach to Strengthen the Quality and Safety of Caesarean Sections in Makueni County, Kenya 

Women in African countries continue to suffer high complications and death from unsafe caesarean section (CS) due to lack of surgical and nonsurgical skills. A multidisciplinary team-based approach is an essential, effective, and patient-centered service delivery approach that enables positive outcomes. The Johnson and Johnson-funded Obstetric Safe Surgery (OSS) project in Makueni County, Kenya, aimed to overcome barriers to safe, timely, and quality CS by using a multidisciplinary team-based approach tailored to the local context. The interventions included improvement of nontechnical skills of surgical teams (e.g., to improve teamwork and communication), by standardizing clinical care and creating a patient safety culture.