PreCourse Survey Questions
1) Nationally, who are the maternity care providers and what is their level of training? |
2) Who will be attending the ALSO course? Where are they from and what is their level of training? |
3) Where are births occurring—hospitals, homes, birth centers—and what is the level of care at each site (ie, what proportion of rural hospitals can perform a cesarean section)? |
4) What are culture-specific attitudes and practices relevant to the birthing process? |
5) What are the rural and urban cesarean section rates? |
Ecuadorian hospitals have rates of 50%, which may mean any woman with a mildly concerning strip, need of operative vaginal delivery, or prior cesarean section is delivered by cesarean. The talk on dystocia may need to be reformulated into a discussion on advantages of vaginal delivery versus cesarean section, issues of patient choice, etc. |
6) What is cesarean section availability in rural and urban areas? |
7) What are local practices regarding breech delivery? If vaginal breech delivery is the norm, this becomes a more important focus. ALSO materials could be supplemented with video footage of breech deliveries. |
8) What are the leading causes of maternal and infant mortality? How common are perinatal conditions such as preeclampsia, preterm delivery, Group B streptococci infection, HIV, and other sexually transmitted diseasess? |
9) Which of the optional ALSO workshops will be most useful? |
10) Are newborn resuscitation program (NRP) courses available? |
A Spanish-translation of the NRP manual and CD are available. Offering the NRP course before or after the ALSO courses may amplify the potential of the courses to reduce perinatal mortality. |
11) What is the availability of and experience with different technologies, including: manual vacuum aspiration for first trimester loss, prenatal ultrasound, vacuum, forceps, and fetal monitoring? |
12) What is the availability of medicines, including: magnesium sulfate, terbutaline, carboprost, misoprostol, and methylergonovine maleate? |
13) What is the cost and availability of laboratory testing? |
The recommendations for universal testing for group B streptococci and HIV testing may be reconsidered. Recommendations for Kleihauer-Betke testing may not be realistic. |
14) What audiovisual aids and equipment are available? |