Sri Lanka College of Obstetricians & Gynaecologists.

The Project commenced in June 2005 and will be completed shortly. This is the first ever income generating project that was undertaken by the SLCOG. It was formulated to address issues relating to the efficiency and quality of health care delivery at state hospitals and was piloted in the Southern and Uva provinces. The project was sponsored by the World Bank and monitored by the Ministry of Health and Nutrition.

The scope of the project was;

carrying out a survey and based on data collected, evaluating the existing facilities at difference levels of hospitals and ascertaining the deficiencies in facilities and in skills of the service providers,
determination of appropriate standards for maternal care for each level of hospital,
development of a set of best-practice guidelines applicable to each level of hospital,
assist in improving knowledge, skills, practices and attitudes of health care providers in the two provinces to achieve the appropriate standards.

Development of Best-practice Guidelines

The project subcommittee identified with the assistance of senior SLCOG members, eleven most suitable aspects in the delivery of maternal care that should be dealt with by way of guidelines. Teams of S.L.C.O.G. members from different parts of the country were set up and each group was given the task of developing a guideline on one of the topics identified. Eleven guidelines were compiled and relevant wall charts were developed. These were handed over to the Ministry of Health and have already been distributed to the hospitals in the two provinces. This is the first time in the South East Asian region that best-practice guidelines at national level have been developed.

Survey

Simultaneously, with the development of guidelines, the project sub committee undertook the development of an instrument to collect data on available facilities, equipment, infrastructure and the skills and attitudes of all personnel at hospitals engaged in the provision of maternal care services at the different hospitals in the two provinces. The collection of data was outsourced and the project timing was slightly delayed due to non-availability of data on time, as this delayed the evaluation process and analysis.

By the evaluation and analysis of the data collected, six clinical situations requiring further training and skill development were identified.

The results of the survey also brought to light the deficiencies and excesses in equipment, personnel and facilities at the different hospitals.

A report on the findings of the survey was presented to The Ministry of Health. The report included recommendations for equitable distribution of equipment and personnel for efficiency and cost effectiveness.

Development of training modules and conducting training programmes

Six different groups of members of The S.L.C.O.G. from different parts of the country were set up and each group was given the task of developing a training module each for the six clinical situations identified. The training groups developed the six training modules and conducted twelve training programmes in the two provinces, for core-groups with the participation of the VOG at the training centre. The core-group will in turn disseminate the knowledge and skills gained by them through such training to other personnel in the satellite hospitals.

The final phase of the project is an evaluation of the impact on maternal mortality and morbidity by the use of the guidelines and the training provided.

Dr. Sarath Amarasekera
Chairperson – HSDP – sub committee