{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:20:09Z","timestamp":1792887609712,"version":"4.5.0"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T00:00:00Z","timestamp":1405555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T00:00:00Z","timestamp":1405555200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":411,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"British Council Development Partnerships in Higher Education"},{"name":"Emergency Obstetrical Training (EmOC)"},{"name":"Society of Obstetricians and Gynecologists of Canada"},{"name":"Association of Obstetricians and Gynecologists of Uganda"},{"DOI":"10.13039\/501100009914","name":"Makerere University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009914","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Mount Sinai Hospital, Toronto, Department of Obstetrics and Gynecology Research"},{"name":"British Council Development Partnerships in Higher Education"},{"name":"Mount Sinai Hospital, Toronto, Department of Obstetrics and Gynecology Research"},{"name":"Makerere University"},{"name":"Association of Obstetricians and Gynecologists of Uganda"},{"name":"Society of Obstetricians and Gynecologists of Canada"},{"name":"Emergency Obstetrical Training (EmOC)"}],"content-domain":{"domain":["ijgo.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the impact of introducing an emergency obstetric and neonatal care training program on maternal and perinatal morbidity and mortality at Moi Teaching and Referral Hospital, Eldoret, Kenya.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective chart review was conducted of all deliveries during the 3\u2010month period (November 2009 to January 2010) before the introduction of the Advances in Labor and Risk Management International Program (AIP), and in the 3\u2010month period (August\u2013November 2011) 1 year after the introduction of the AIP. All women who were admitted and delivered after 28 weeks of pregnancy were included. The primary outcome was the direct obstetric case fatality rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1741 deliveries occurred during the baseline period and 1812 in the postintervention period. Only one mother died in each period. However, postpartum hemorrhage rates decreased, affecting 59 (3.5%) of 1669 patients before implementation and 40 (2.3%) of 1751 afterwards (<jats:italic>P<\/jats:italic> = 0.029). The number of patients who received oxytocin increased from 829 (47.6%) to 1669 (92.1%; <jats:italic>P<\/jats:italic> &lt; 0.001). Additionally, the number of neonates with 5\u2010minute Apgar scores of less than 5 reduced from 133 (7.7%) of 1717 to 95 (5.4%) of 1745 (<jats:italic>P<\/jats:italic> = 0.006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The introduction of the AIP improved maternal outcomes. There were significant differences related to use of oxytocin and postpartum hemorrhage.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2014.05.023","type":"journal-article","created":{"date-parts":[[2014,7,17]],"date-time":"2014-07-17T07:31:58Z","timestamp":1405582318000},"page":"189-193","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":24,"title":["One\u2010year evaluation of the impact of an emergency obstetric and neonatal care training program in Western Kenya"],"prefix":"10.1002","volume":"127","author":[{"given":"Rachel F.","family":"Spitzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Jane","family":"Steele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Caloia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Thorne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan D.","family":"Bocking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Christoffersen\u2010Deb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Yarmoshuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loise","family":"Maina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Sitters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Chemwolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elkanah","family":"Omenge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,7,17]]},"reference":[{"key":"e_1_2_6_2_2","unstructured":"United Nations 55\/2. United Nations Millennium Declaration.http:\/\/www.un.org\/millennium\/declaration\/ares552e.pdf Published September 18 2000. Accessed June 23 2014"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_6_4_2","unstructured":"Kenya National Bureau of Statistics Kenya Demographic and Health Survey 2008\u201309.http:\/\/www.unfpa.org\/sowmy\/resources\/docs\/library\/R313_KNBS_2010_Kenya_DHS_2009_final_report.pdf Published June 2010. Accessed June 23 2014"},{"key":"e_1_2_6_5_2","unstructured":"WHO ICM FIGO Making pregnancy safer: the critical role of the skilled attendant.http:\/\/whqlibdoc.who.int\/publications\/2004\/9241591692.pdf?ua=1 Published 2004. Accessed June 23 2014"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.06.038455"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02561.x"},{"key":"e_1_2_6_8_2","first-page":"CD005460","article-title":"Traditional birth attendant training for improving health behaviours and pregnancy outcomes","volume":"8","author":"Sibley L.M.","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_9_2","first-page":"97","volume-title":"Safe Motherhood Strategies: a Review of the Evidence","author":"Graham W.J.","year":"2001"},{"issue":"3","key":"e_1_2_6_10_2","first-page":"187","article-title":"The effects of the ALSO course as an educational intervention for residents. Advanced Life Support in Obstetrics","volume":"29","author":"Bower D.J.","year":"1997","journal-title":"Fam Med"},{"issue":"2","key":"e_1_2_6_11_2","first-page":"103","article-title":"Reported comfort with obstetrical emergencies before and after participation in the advanced life support in obstetrics course","volume":"30","author":"Taylor H.A.","year":"1998","journal-title":"Fam Med"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01115.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60593-0"},{"key":"e_1_2_6_14_2","volume-title":"ALARM International: A Program to Reduce Maternal and Neonatal Mortality and Morbidity","author":"Society of Obstetricians and Gynaecologists of Canada","year":"2008"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-10-85"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.05.028"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729214003580?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/api.elsevier.com\/content\/article\/PII:S0020729214003580?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2014.05.023","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.ijgo.2014.05.023","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.ijgo.2014.05.023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T19:14:30Z","timestamp":1743794070000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1016\/j.ijgo.2014.05.023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,17]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,11]]}},"alternative-id":["10.1016\/j.ijgo.2014.05.023"],"URL":"https:\/\/doi.org\/10.1016\/j.ijgo.2014.05.023","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7,17]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"One-year evaluation of the impact of an emergency obstetric and neonatal care training program in Western Kenya","name":"articletitle","label":"Article Title"},{"value":"International Journal of Gynecology & Obstetrics","name":"journaltitle","label":"Journal Title"},{"value":"http:\/\/dx.doi.org\/10.1016\/j.ijgo.2014.05.023","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2014 Published by Elsevier Ireland Ltd.","name":"copyright","label":"Copyright"}]}}