Applying the RE-AIM framework in a process evaluation of the introduction of the Non-Pneumatic Anti-Shock Garment in a rural district of Zimbabwe

• DOI: 10.1371/journal.pone.0251908
• Publication Date: 2021-05-20T17:44:34Z
• Authors: Thulani Leslie Ma...; Abaden Svisva; Tarryn Bowers; Fishiwe Chiyaka; Jenna-Dawn Conway; Bernard Madzima; Violet Mambo; Alexio Mangwiro; Andy Elizabeth Ca...
• Keywords: Adult; Zimbabwe; Science; Q; Postpartum Hemorrhage; Pregnancy Complications, Hematologic; R; Shock; World Health Organization; Clothing; Obstetric Labor Complications; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Pregnancy; Maternal Death; Medicine; First Aid; Humans; Female; Research Article

The Non-Pneumatic Anti-Shock Garment (NASG) is a first aid tool that can halt and reverse hypovolemic shock secondary to obstetric hemorrhage. World Health Organization recommended the NASG for use as temporizing measure in 2012, but uptake of recommendation has been slow, partially because operational experience limited. study process evaluation introduction public sector health facility network rural Zimbabwe utilizing an adapted RE-AIM, categorizing observations into domains of: reach, effectiveness, adoption, implementation maintenance. location was Hurungwe district, where staff members 34 facilities at primary (31), (2) tertiary (1) levels care participated. We found all became skilled using NASG, used 10 11 instances severe In cases used, there were no maternal deaths extreme adverse outcomes related hemorrhage period. Among uses, garment correctly each case. Fidelity processes high, especially regard training cascading skills, revisions rotation replacement operating procedures required keep clean garments stocked. Clinical documentation also key challenge. dovetailed very well with pre-existing systems emergency response, improved clinical outcomes. Scale-up Zimbabwean system be undertaken careful attention mentorship, drills, logistics.