By George Anguh
The Medical Dictionary sees Obstetrics as the branch of medicine that deals with the care of women during pregnancy, childbirth, and the recuperative period following delivery. This medical specialty requires professionalism in clinical practice. Consequently, the CBC Health Services has put a specialized program in place to handle obstetric concerns within and beyond the system. The program is called, Advanced Life Support in Obstetrics (ALSO).
ALSO is a training program that was designed by two Americans in the early nineties. In 1993, the American Academy of Family Physicians acquired the course and owned the license. So far, there are 47 authorized countries in the world that have the right to organize courses to train people who are involved in obstetric care.
The CBC Health Services thanks to Dr. Thomas Welty and his wife Dr. Edith Welty, who got the license in 2012 to carry out ALSO trainings in Cameroon. The need for such a program had become more pressing given that with the Millennium Development Goals (MDGs), maternal mortality throughout the world did not reduce by 75% by 2015 as was expected. Following the data that was collected in Cameroon in 2012, it was discovered that maternal mortality had risen to 1000 per 100,000 deliveries.
Given the dilemma, the Weltys who have a track record of achievements in maternal and child health in Cameroon through the CBC Health Services, contemplated on what they could do in curbing maternal mortality in the country. Their pursuit for a solution made them to search around the world for best practices in the battle against maternal mortality. Considering the fact that some countries around the world had succeeded in reducing maternal mortality by equipping healthcare providers with skills required for caring for pregnant women, the Weltys then influenced the introduction of ALSO to Cameroon via the CBC Health Services.
Mrs. Mbah Rahel is the CBC Health Services’ ALSO Program Coordinator and works closely with Mr. Munjoh Anthony, ALSO Program Director who doubles as the Supervisor of Nursing Services for Mboppi Baptist Hospital Douala (MBHD).
The introductory and elementary phase of the ALSO training is called Basic Life Support in Obstetrics (BLSO). It is intended to equip those who attend to pregnant women, with basic skills to be able to know when to refer cases from primary health facilities to more advanced healthcare facilities and hospitals. Therefore, the program is run in close synergy with the Life Abundant Primary Health Care program (LAP), which runs over 54 primary healthcare facilities in the remotest parts of Cameroon.
“So far, we have trained over 500 Cameroonians in the CBC Health Services, the peripheral health services and in the government hospitals in the Northwest and Southwest regions of Cameroon,” Says Mr. Munjoh Anthony.
Lillian Nsetie Njini is a nurse assistant at the Mbingo Baptist Hospital Maternity. She recently attended one of the BLSO trainings at LAP Bamkikai from September 6-8, 2018. Quizzed on how the training has impacted her career she said, “I have learned how to manage shoulder dystocia which is a complication that may arise during delivery. Though I am not a midwife, I believe I can give good assistance whenever I am called to do so during delivery.”
Haran Kuma from Nyamboya Integrated Health Center is another recent ALSO trainee. “I have benefited a lot from this training. I learned some tips on how to manage a woman who is bleeding after delivery; a condition known as postpartum hemorrhage. I am going to help more pregnant women by giving them better care,” says Haran. .
Going by Mrs. Mbah Rahel’s account, Advanced Life Support in Obstetrics (ALSO) is an evidence-based, inter-professional, and multidisciplinary training program that equips the entire maternity care team with skills to effectively manage obstetric emergencies. This comprehensive course encourages a standardized team-based approach amongst physicians, residents, nurses midwives, registered nurses and other members of the maternity care team to improve patient safety and positively impact maternal outcomes.
On the other hand, Mrs. Mbah describes the BLSO training as a 3-day training which ends with the trainees taking a test. Prior to the training, the manuals for the training are sent out to the participants who should be people who work with pregnant women. The participants are expected to study the manual in order to get prepared for the training. The training is a combination of theory and practicum.
Evidently, the goal of reducing maternal mortality in Cameroon is gradually being attained. If we consider Banso Baptist Hospital (BBH), Mbingo Baptist Hospital (MBH) and Baptist Hospital Mutengene (BHM) as cases in point, we see that the few maternal deaths recorded in these medical facilities over the last 6 years since the training began have been due to late referrals and not the lack of skills by the health personnel. Mboppi Baptist Hospital Douala is an outstanding example of the success of the ALSO program in Cameroon. Since the training was done in this hospital, over 30,000 deliveries have been done with less than 15 maternal deaths.