Continuing our series on the Irish Healthcare Awards, Valerie Ryan reports on how a small group of committed people in Ireland and Sudan linked up to achieve massive gains in maternal and perinatal outcomes
A seven-year hospital management partnership between Ireland and Sudan, which aimed to improve maternal and perinatal outcomes, saw an 86 per cent reduction in maternal mortality and a drop of 50 per cent in stillbirths at a Khartoum-based maternity hospital.
The impressive collaborative project carried off the Excellence in Healthcare Management Award for Cork University Maternity Hospital (CUMH) and Omdurman Hospital in Khartoum; the work was also commended in the Best Hospital Project category of the Irish Medical Times Healthcare Awards last year.
The Sudanese partners brought the Irish award back to Omdurman and put it on display, but it was also decided to create a replica to place at the entrance. So a five-foot gold-coloured replica of the IMT Excellence in Healthcare Management Award now stands at the entrance to the hospital.
Their achievement was followed by an award from the Sudanese Ministry for Health, in recognition of the advances and achievements of the Omdurman Maternity Hospital in the state of Khartoum.
The improvements at the largest maternity hospital in Sudan were further underlined by capital investment from its government, which has allowed a new maternity wing to be built at the facility. Prof Tony Ryan, UCC Associate Professor of Paediatrics/Neonatology, believes the award from the Sudanese government, and the capital investment, resulted directly from the joint project receiving the national IMT Healthcare Award last year.
Goals and objectives
Work is under way compiling the latest statistics for the Sudanese maternity hospital, which caters for 25,000 deliveries per annum, according to Prof Ryan, and they are preparing the data from the past 12 months for publication. He stressed that the changes that were implemented during the initiative were made by the Omdurman Maternity Hospital, which set its own goals and objectives. The doctors and staff from Cork University Maternity Hospital were there and willing to help in whatever way they could.
While the formal partnership, which ran between 2002 and 2009, has now been completed, the links will continue between CUMH/UCC and the Sudanese hospital for educational and other contacts.
The institutions involved in the collaboration included the Departments of Obstetrics & Gynaecology and Paediatrics, at the University of Khartoum; the Departments of Obstetrics & Gynaecology, Neonatology and Nursing at Cork University Maternity Hospital and UCC; and Paediatrics and Child Health at UCC.
Another group has just been out to the Sudanese hospital; two biomedical technologists have carried out repair work on equipment that had been sent out from Cork and have delivered training to local technologists at the hospital. In addition, a UCC medical student is to spend six weeks in the Khartoum hospital on a Surgeon Noonan elective.
Prof Ryan believes sustainability is critical for the Sudanese hospital to continue with its achievements. He likened the factors that helped the project to some of the concepts in Malcolm Gladwell’s The Tipping Point: How Little Things Can Make a Big Difference. A small group of committed people was able to make a difference.
The connections between the Cork and Omdurman Maternity Hospitals helped to keep the doctors in Sudan. Prof Ryan said it was a great opportunity for them and for Cork University Maternity Hospital in terms of what could be achieved. The international links and friendships had a deep impact on the Irish healthcare staff involved in the joint project.
He is optimistic that the achievement by the Omdurman Maternity Hospital will lead to further successes. Nonetheless, one of the other challenges that remains for the Sudanese hospital is that most women do not receive antenatal care, and this has a negative impact on neonatal mortality rates.
Cork amalgamation
The award-winning project with the Khartoum hospital, ‘Upgrading health systems to reduce maternal and perinatal mortality’, was originally prompted through a series of contacts between Cork and Sudanese doctors.
Then, as the three Cork maternity hospitals were preparing to amalgamate into the new Cork University Maternity Hospital, health professionals in the Cork services felt they had a contribution to offer to Sudan’s largest maternity hospital, in a country where maternal mortality is 200-fold higher than in Ireland.
The amalgamation of service to the new Cork University Maternity Hospital dovetailed as Cork transferred as-new equipment from the Erinville, St Finbarr’s and the Bon Secours hospitals. Work on the Cork University Maternity Hospital began in late 2002 and it opened in March 2007.
Government grants
A generous grant from Irish Aid, matched by the Sudanese government, helped facilitate the collaborative project in a number of ways. As part of the project, ten multidisciplinary teams made educational visits to the Khartoum facility, delivering management, emergency and other training sessions.
The project aimed to implement evidence-based and efficient obstetrics and gynaecology, neonatal and midwifery clinical practice to reduce maternal and perinatal mortality. There were two return visits from Omdurman Hospital, and as-new equipment transferred from the three Cork maternity hospitals included items such as beds, cots, warmers and ventilators. Health professionals who travelled to the Omdurman Maternity Hospital included consultants, EMTs and technicians.
During the partnership, there was a reduction of almost 50 per cent in stillbirth rates, from 33 per 1,000 to 19 per 1,000 in 2007. The Sudanese government invested in a new special care baby unit and a general laboratory as part of the initiative.
Other measures undertaken at the hospital during the initiative were aimed at improving areas such as waste management, infection control and hygiene and IT, as well as further developing some existing services.
Prof Ryan is now hoping to start up another collaborative project, this time in the community to train midwives in resuscitation techniques for newborns.
There are 14 different healthcare award categories open to entrants in 2010. IMT is looking to hear from anyone who has identified a potential idea in the past year and developed a project aimed at improving the delivery of healthcare.
The entries in the Irish Healthcare Awards are judged by an independent panel of experts who look for ideas that solve problems in the health service, bridge gaps and improve patients’ lives.
“We are looking for projects and initiatives that demonstrate originality, innovation and excellence,” said IMT’s Dylan Conway.
l For further information on any aspect of the 2010 Awards contact Dylan at tel: (01) 8176330 or email: dylan.conway@imt.ie
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