Improving fetal dystocia management using simulation in Senegal: midterm results

Mamour Gueye, Philippe Marc Moreira, Moussa Diallo, Omar Gasama, Mohamed Diadhiou, Mame Diarra Ndiaye Gueye, Serigne Modou Kane Gueye, Marie Edouard Faye Dieme, Abdoul Aziz Diouf, Mouhamadou Mansour Niang, Dior Dieng, Ousmane Ndiaye, Alassane Diouf, Jean Charles Moreau


Background: Maternal mortality, which constitutes the extreme point of the existing inequality between women in poor and rich countries, remains very high in Africa south of the Sahara. The objective of this study was to introduce a new training approach in Emergency Obstetric and Neonatal Care (EmONC) entered in Senegal to strengthen the skills of healthcare providers.

Methods: The approach was based on the skills training using the so-called "humanist" method and "lifesaving skills". Simulated practice took place in the classroom through thirteen clinical stations summarizing the clinical skills on EmONC. The evaluation was done in all phases and the results were recorded in a database to document the progress of each learner.

Results: With this approach, 432 providers were trained in 10 months. The increase in technical achievements of each participant was documented through the database. The combination of training based on the model “learning by doing” has ensured learning and mastering all EmONC skills and reduced missed learning opportunities as observed in former EmONC trainings.

Conclusions: The impact of training on EmONC indicators and the introduction of this learning modality in basic training are the two major challenges in terms of prospects.


Dystocia, Emergency obstetric care, Training, Training models

Full Text:



Sullivan R. Clinical Training Competencies for Reproductive Health Professionals. JHPIEGO Corporation: Baltimore, Maryland; 1995.

van den Broekn N. Lifesaving skills manual. RCOG, London. 2007.

World Health Organization. Management of complications of pregnancy and childbirth: a guide for the midwife and physician. Geneva. 2004.

WHO, UNFPA, UNICEF, Bank W. Managing complications in pregnancy and childbirth. WHO/RHR/00.7, 2000. Available at

Elbourne DR, Prendiville WJ, Carroli G, Wood J, McDonald S. Prophylactic use of oxytocin in the third stage of labour. In: The Cochran Library; Oxford. Update Software. 2003;3.

Prendiville WJ, Elbourne D, McDonald S. Active versus expectant management in the third stage of labour. In: The Cochrane Library. Oxford: Update Software; 2003;3.

Joy SD, Sanchez-Ramos L, Kaunitz AM. Misoprostol use during the third stage of labor. Int J Gynecol Obstet. 2003;82:143-52.

Maslovitz S, Barkai G, Lessing JB, Ziv A, Many A. Recurrent obstetric management mistakes identified by simulation. Obstet Gynecol. 2007;109:1295-300.

Birch L, Jones N, Doyle PM. Obstetric skills drills: Evaluation of teaching methods. Nurse Educ Today. 2007;27:915-22.