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The SEA-ORCHID project evaluated the adoption of evidence-based practices for maternal and neonatal health across hospitals in four Southeast Asian countries. The study found that few practices were consistent with best evidence from organizations like Cochrane and WHO. Specifically, appropriate antibiotic prophylaxis for c-sections, antenatal corticosteroids for preterm birth risk, and family support during labor were rarely performed. Barriers to implementing evidence-based practices varied between hospitals and countries. The results were used to identify barriers and develop strategies to increase evidence-based care and improve perinatal health outcomes.

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50 views2 pages

Ebr 1 (Ob Ii)

The SEA-ORCHID project evaluated the adoption of evidence-based practices for maternal and neonatal health across hospitals in four Southeast Asian countries. The study found that few practices were consistent with best evidence from organizations like Cochrane and WHO. Specifically, appropriate antibiotic prophylaxis for c-sections, antenatal corticosteroids for preterm birth risk, and family support during labor were rarely performed. Barriers to implementing evidence-based practices varied between hospitals and countries. The results were used to identify barriers and develop strategies to increase evidence-based care and improve perinatal health outcomes.

Uploaded by

Kathleen Josol
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Use of Evidence-Based Practices in Pregnancy and

Childbirth: South East Asia Optimising Reproductiv
e and Child Health in Developing Countries Project
The burden of mortality and morbidity related to pregnancy and childbirth remains concentrated
in developing countries. This disparity continues with rates of neonatal mortality almost 10 times
greater in South East Asia than developed regions. SEA-ORCHID, a five-year project, is
evaluating whether a multifaceted intervention to strengthen capacity for research synthesis,
evidence-based care and knowledge implementation improves adoption of best clinical practice
recommendations and so leads to better health for mothers and babies. This describes
empirical evidence of current practices at the beginning of the SEA-ORCHID project for key
aspects of maternal and perinatal health care in the participating countries.

Indonesia, Malaysia, The Philippines and Thailand were included, with support from
three sites in Australia. Different types of hospital were represented including tertiary
referral hospitals (University and regional), provincial hospitals and district hospitals. All
were selected as part of the SEA-ORCHID project.

Seven of the hospitals were tertiary referral institutions with regional referrals of women
with a high risk pregnancy. Two hospitals were provincial or district institutions. Models
of delivery care included a multidisciplinary approach with midwives (including nurses
with midwifery qualifications) or obstetric specialists. All hospitals had obstetric
specialists and caesarean section facilities available. Normal vaginal births were
conducted by doctors and/or midwives (including nurses with midwifery qualifications) in
all hospitals.

The SEA-ORCHID project settings and methods have been published elsewhere. The
project was approved by the local ethics committee of each hospital and by the ethics
committee of the administering institution in Australia (University of Sydney).

The principles of evidence-based practice are to encourage health professionals to use


practices with proven benefit and eliminate the use of those shown to be ineffective or
harmful. Effective implementation of beneficial practices in developing regions, such as
South East Asia, should lead to a reduction in maternal and neonatal mortality and
morbidities.

There is clear evidence of benefit to perinatal health outcomes with use of appropriate
antibiotic prophylaxis for caesarean section, use of antenatal corticosteroids for women
at risk of preterm birth and family support during labour. Our findings however, show
that these clinical practices were rarely performed in most of the included hospitals, with
high rates of variation across the countries. It is likely that there are a range of barriers
to all these clinical practices.
In summary, few practices of perinatal health care in the nine hospitals within the four
South East Asian countries were consistent with best available evidence from Cochrane
reviews and the World Health Organization Reproductive Health Library
recommendations. At the individual hospitals the audit results were used to evaluate the
barriers to adoption of appropriate practices and elimination of inappropriate practices
followed by strategies to increase the use of evidence-based practices in perinatal
health care.

Reference:

The SEA-ORCHID Study Group (2008) Use of Evidence-Based Practices in Pregnancy


and Childbirth: South East Asia Optimising Reproductive
and Child Health in Developing Countries Project. PLoS ONE 3(7): e2646.
doi:10.1371/journal.pone.0002646

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