The women of  Africa

EMONC program

Piloting obstetric care improvement initiatives at Tygerberg Hospital

An effort is underway to improve healthcare delivery throughout the rural areas of South Africa. We have begun exploring opportunities to provide technology, know-how training, and maintenance infrastructure to facilitate diagnoses and treatment advice.

 

Our collaboration with Tygerberg Hospital is part of a larger “Quality Improvement” initiative and is the first of four programs focusing on the development of rural healthcare solutions throughout Africa.

 

Based on discussions with our Tygerberg partners, a pilot program was designed to investigate challenges and requirements in urban hospitals, in order to make more informed and educated plans for rural demands.

Easing the burden

The Obstetric Critical Care Unit (OCCU) at Tygerberg provides infrastructure, equipment and medical personnel for early resuscitation, and intensive monitoring of mothers and unborn babies. Morbidity in the OCCU was increasing due to a steady 95% occupation rate and an increase in the admission of severely ill patients.

 

In May of 2012, Philips helped Tygerberg create a ‘step-down’ unit, or Emergency Obstetric Newborn Care Unit (EmONC), designed to improve the ability of the OCCU to manage high-risk pregnancies and complications. Stable patients could be moved from the OCCU to the EmONC, yet still receive critical monitoring care. Philips supplied monitors and a central station (plus training) for the EmONC.

Critical learning for application across Africa

The pilot program has been extremely effective. Of the 800 mothers (70 more than the year before) who were admitted to the EmONC, 535 participated in a trial study. Results show a decreased mortality rate from 6% to 0% in just 8 weeks. Furthermore, the mortality rate has been constant at 0% during the full year of the trial. And this was accomplished with nurse assistants running the EmONC, leaving trained nurses to focus on the ICU.1

 

“Together with Philips, we have tested a blue-print of the ideal obstetric critical care unit for all levels of hospitals in South Africa,” commented Dr. Eduard Langenegger, Head of the Obstetric Critical Care Unit at Tygerberg. “With the capability of transferring patients that are stable, but still in need of continuous monitoring to the acute postnatal step-down unit. We hope that this project can be continued and serve as a template for other hospitals in Southern Africa.”

¹Langenegger E. & De Clerck L. (2013) Tygerberg Hospital: Strengthening care coordination and care stratification. Capetown: Philips

 

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