Improving the recognition and management of maternal sepsis in Malawi


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Cheshire, James Robert Chamberlain (2020). Improving the recognition and management of maternal sepsis in Malawi. University of Birmingham. Ph.D.

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Introduction: Maternal sepsis is the third most common direct cause of maternal mortality worldwide. This thesis describes the development and evaluation of the “FAST-M” intervention, which sought to improve the recognition and management of maternal sepsis in a low-resource setting.

Methods: A prospective, multi-centre, controlled study, with a before and after design was conducted using a mixed-methods approach to data collection and analysis. The study sought to determine the feasibility of implementing the FAST-M intervention across fifteen healthcare facilities in Malawi and evaluate subsequent improvements in sepsis care.

Results: As a result of the FAST-M intervention, patients received more regular monitoring of their vital signs. Patients with suspected maternal sepsis were treated sooner and were more likely to receive all components of the FAST-M treatment bundle within one hour of sepsis recognition. Overall, the FAST-M intervention was feasible to implement, gaining widespread acceptability amongst staff with high levels of adoption and fidelity. There were no reported negative consequences of implementing the intervention.

Conclusions: Implementation of the FAST-M intervention in a low-resource setting was feasible and led to the improved recognition and management of maternal sepsis. Lessons learnt during this feasibility work will inform its future scaling up and formal evaluation.

Type of Work: Thesis (Doctorates > Ph.D.)
Award Type: Doctorates > Ph.D.
Licence: All rights reserved
College/Faculty: Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department: Institute of Metabolism and Systems Research
Funders: Other
Other Funders: MSD for Mothers, University of Birmingham, Ammalife
Subjects: R Medicine > RG Gynecology and obstetrics


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