{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:40:24Z","timestamp":1792798824396,"version":"4.5.0"},"reference-count":27,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012324","name":"University Hospitals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012324","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["AJOG Global Reports"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.xagr.2026.100663","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T23:27:29Z","timestamp":1781652449000},"page":"100663","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Decline in maternal mortality in Guyana observed after development and implementation of obstetrics and gynecology residency training program"],"prefix":"10.1016","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2770-6931","authenticated-orcid":false,"given":"Megan","family":"Quimper","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2968-4047","authenticated-orcid":false,"given":"John","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2836-0206","authenticated-orcid":false,"given":"Lindsey E.","family":"Zamora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1041-5659","authenticated-orcid":false,"given":"Natasha","family":"France","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9848-4055","authenticated-orcid":false,"given":"Hardeo","family":"Ramdeholl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9151-6077","authenticated-orcid":false,"given":"Ademola","family":"Biala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0916-477X","authenticated-orcid":false,"given":"Geremias","family":"Rangel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4762-1601","authenticated-orcid":false,"given":"James","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0004-7696","authenticated-orcid":false,"given":"Madan","family":"Rambaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5701-4492","authenticated-orcid":false,"given":"Lena","family":"Wiley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3089-5657","authenticated-orcid":false,"given":"Tia","family":"Melton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3813-8692","authenticated-orcid":false,"given":"Mary Frances","family":"Haerr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9410-4462","authenticated-orcid":false,"given":"Margaret","family":"Larkins-Pettigrew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.xagr.2026.100663_bib0001","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/0020-7292(95)02498-2","article-title":"The mother-baby package: an approach to implementing safe motherhood","volume":"50","author":"Mehta","year":"1995","journal-title":"Int J Gynecol Obstet"},{"key":"10.1016\/j.xagr.2026.100663_bib0002","unstructured":"Transforming our world: the 2030 agenda for sustainable development. New York (NY): United Nations; 2015 Available at: https:\/\/sustainabledevelopment.un.org\/post2015\/transformingourworld. Accessed Jul. 23 2025."},{"key":"10.1016\/j.xagr.2026.100663_bib0003","unstructured":"World Health Organization 2025 data.who.int, Maternal mortality ratio (per 100,000 live births). Available at: https:\/\/data.who.int\/indicators\/i\/C071DCV\/AC597B1. Accessed Jul. 23 2025."},{"key":"10.1016\/j.xagr.2026.100663_bib0004","series-title":"Guyana Country Cooperation Strategy 2010-2015","year":"2009"},{"key":"10.1016\/j.xagr.2026.100663_bib0005","doi-asserted-by":"crossref","first-page":"131","DOI":"10.3109\/13561820903417426","article-title":"Interprofessional education and collaborative practice","volume":"24","author":"Ramsammy","year":"2010","journal-title":"J Interprof Care"},{"key":"10.1016\/j.xagr.2026.100663_bib0006","doi-asserted-by":"crossref","first-page":"477","DOI":"10.5811\/westjem.2013.3.12714","article-title":"Emergency medicine in Guyana: Lessons from developing the country\u2019s first degree-conferring residency program","volume":"14","author":"Forget","year":"2013","journal-title":"West J Emerg Med"},{"issue":"Suppl I","key":"10.1016\/j.xagr.2026.100663_bib0007","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1186\/1471-2458-9-S1-S7","article-title":"Addressing the migration of health professionals: the role of working conditions and educational placements","volume":"9","author":"Witt","year":"2009","journal-title":"BMC Public Health"},{"key":"10.1016\/j.xagr.2026.100663_bib0008","unstructured":"JustWONDOOR. Published 2019. Accessed Jul. 23 2025. Available at: https:\/\/www.justwondoor.org."},{"key":"10.1016\/j.xagr.2026.100663_bib0009","unstructured":"ACGME Program Requirements for Graduate Medical Education in Obstetrics and Gynecology. Accessed Jul. 23 2025. Available at: https:\/\/www.acgme.org\/globalassets\/pfassets\/programrequirements\/2025-reformatted-requirements\/220_obstetricsgynecology_2025_reformatted.pdf."},{"key":"10.1016\/j.xagr.2026.100663_bib0010","unstructured":"Council on Resident Education in Obstetrics and Gynecology Educational Objectives Core Curriculum in Obstetrics and Gynecology 13th Edition. Accessed Jul. 23 2025. Available at: https:\/\/www.acog.org\/_\/media\/project\/acog\/acogorg\/files\/creog\/creog-educational-objectives-13thedition.pdf?rev=53bf30ec0f144132a8d81d81549b2476"},{"key":"10.1016\/j.xagr.2026.100663_bib0011","doi-asserted-by":"crossref","first-page":"257","DOI":"10.52403\/ijrr.20220928","article-title":"The maternal and perinatal outcomes of pregnancies complicated by COVID-19: a retrospective study at a tertiary facility in Guyana (Georgetown Public Hospital Corporation)","volume":"9","author":"Biala","year":"2022","journal-title":"Int J Res Rev"},{"key":"10.1016\/j.xagr.2026.100663_bib0012","doi-asserted-by":"crossref","first-page":"334","DOI":"10.52403\/ijrr.20220936","article-title":"A retrospective chart review study: analysis of cesarean sections using Robson 10-group classification system at the Georgetown Public Hospital Corporation","volume":"9","author":"Biala","year":"2022","journal-title":"Int J Res Rev"},{"key":"10.1016\/j.xagr.2026.100663_bib0013","doi-asserted-by":"crossref","first-page":"409","DOI":"10.52403\/ijrr.20221155","article-title":"Cervical cancer: incidence, clinical staging at presentation and treatment modality from October 2020-March 2021","volume":"9","author":"Usen","year":"2022","journal-title":"Int J Res Rev"},{"key":"10.1016\/j.xagr.2026.100663_bib0014","first-page":"54","article-title":"Secondary abdominal ectopic pregnancy after a failed attempt at medical termination: a rare case report","volume":"9","author":"Harvey","year":"2026","journal-title":"Int J Res Rep Gynaecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0015","first-page":"1","article-title":"Suspected placental abruption leading to intraoperative diagnosis of rupture of an unscarred uterus in a grand multipara","volume":"2","author":"Gray","year":"2026","journal-title":"J Gynecol Womens Health Care"},{"key":"10.1016\/j.xagr.2026.100663_bib0016","doi-asserted-by":"crossref","first-page":"108","DOI":"10.29063\/ajrh2024\/v28i12.12","article-title":"Surgery for giant ovarian cysts in Guyana using single-port laparoscopy: a retrospective case series analysis","volume":"28","author":"France","year":"2024","journal-title":"Afr J Reprod Health"},{"key":"10.1016\/j.xagr.2026.100663_bib0017","doi-asserted-by":"crossref","first-page":"302","DOI":"10.52403\/ijrr.20221140","article-title":"The incidence and causes of maternal near miss in a pandemic at Georgetown Public Hospital Corporation","volume":"9","author":"Alli","year":"2022","journal-title":"Int J Res Rev"},{"key":"10.1016\/j.xagr.2026.100663_bib0018","first-page":"239","article-title":"The incidence and risk factors of peripartum hysterectomy at the Georgetown Public Hospital Corporation","volume":"5","author":"Seekumarie","year":"2022","journal-title":"Int J Res Rep Gynaecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0019","doi-asserted-by":"crossref","first-page":"194","DOI":"10.52403\/ijrr.20220920","article-title":"Physician burnout at Georgetown Public Hospital (GPHC): the hidden health worker crisis","volume":"9","author":"Singh","year":"2022","journal-title":"Int J Res Rev"},{"key":"10.1016\/j.xagr.2026.100663_bib0020","first-page":"373","article-title":"Fatal rupture of subcapsular hepatic hematoma in preeclampsia with severe features: a catastrophic obstetric emergency","volume":"8","author":"Sookraj","year":"2025","journal-title":"Int J Res Rep Gynaecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0021","first-page":"379","article-title":"A rare case of ovarian ectopic pregnancy diagnosed at a tertiary-level hospital in Guyana","volume":"8","author":"Klass","year":"2025","journal-title":"Int J Res Rep Gynaecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0022","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1097\/AOG.0000000000002965","article-title":"Retroperitoneal ectopic pregnancy","volume":"132","author":"Pak","year":"2018","journal-title":"Obs Gynecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0023","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/AOG.0000000000003317","article-title":"Increased Rwandan access to obstetrician-gynecologists through a U.S.-Rwanda academic training partnership","volume":"134","author":"Small","year":"2019","journal-title":"Obs Gynecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0024","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1067\/S0002-9378(03)00882-2","article-title":"Ghana postgraduate obstetrics\/gynecology collaborative residency training program: success story and model for Africa","volume":"189","author":"Klufio","year":"2003","journal-title":"Am J Obs Gynecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0025","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/01.AOG.0000287064.63051.1c","article-title":"Who will be there when women deliver? Assuring retention of obstetric providers","volume":"110","author":"Anderson","year":"2007","journal-title":"Obs Gynecol"},{"key":"10.1016\/j.xagr.2026.100663_bib0026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12909-020-02446-1","article-title":"Development and launch of the first obstetrics and gynaecology master of medicine residency training programme in Botswana","volume":"21","author":"Luckett","year":"2021","journal-title":"BMC Med Educ"},{"key":"10.1016\/j.xagr.2026.100663_bib0027","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1002\/ijgo.70420","article-title":"Assessment of obstetrics and gynecology training during residency: a global perspective","volume":"170","author":"Topcu","year":"2025","journal-title":"Int J Gynecol Obs"}],"container-title":["AJOG Global Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666577826000614?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666577826000614?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:06:49Z","timestamp":1792796809000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2666577826000614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":27,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["S2666577826000614"],"URL":"https:\/\/doi.org\/10.1016\/j.xagr.2026.100663","relation":{},"ISSN":["2666-5778"],"issn-type":[{"value":"2666-5778","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Decline in maternal mortality in Guyana observed after development and implementation of obstetrics and gynecology residency training program","name":"articletitle","label":"Article Title"},{"value":"AJOG Global Reports","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.xagr.2026.100663","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"100663"}}