A CLEVER way to reduce maternal and perinatal mortality and morbidity: essential respectful high quality obstetric care to birthing mothers is presented innovatively to address the local barriers in the health system, the blind spots in critical thinking during obstetric care and the preferences of the individual clients and their cultures. The package called ‘Working CLEVER’ in delivery units provides a framework for a turn-around within individual labour ward units that reinforces needed routines (including pre-referral care and referrals) and improves practical health worker skills levels through local monitoring and coaching. The package can be disseminated during master training workshops and implemented by district clinical specialist teams and other relevant local clinicians in South Africa.
C linical care
L abour ward management
E liminate barriers
V erify care
E (mergency) O(bstetric) S(imulation) T(
R espectful care
Anne-Marie Bergh
Antonella (Toni) Silver,
Refilwe Malatji
Lizzy Sithole
MSD for Mothers Global Giving
MSD for Mothers has established a 10-year, $500m global initiative to create a world where no woman dies giving birth.
| Oosthuizen, S.J., Bergh, A.-M., Grimbeek, J., and Pattinson, R.C., 2020. CLEVER maternity care: A before-and-after study of women’s experience of childbirth in Tshwane, South Africa. African Journal of Primary Health Care & Family Medicine, 12 (1). DOI: 10.4102/phcfm.v12i1.2560 |
| Oosthuizen, S.J., Bergh, A.-M., Grimbeek, J., and Pattinson, R.C., 2019. Midwife-led obstetric units working ‘CLEVER’: Improving perinatal outcome indicators in a South African health district. South African Medical Journal, 109 (2), 95. DOI: 10.7196/SAMJ.2019.v109i2.13429 |
| Oosthuizen, S.J., Bergh, A.-M., and Pattinson, R.C., 2018. Systems thinking: A turning point for improving respectful obstetric care in South African health districts. South African Medical Journal, 108 (11), 910. DOI: 10.7196/SAMJ.2018.v108i11.13312 |
| Oosthuizen, S.J., Bergh, A.-M., Pattinson, R.C., and Grimbeek, J., 2017. It does matter where you come from: mothers’ experiences of childbirth in midwife obstetric units, Tshwane, South Africa. Reproductive Health, 14 (1). DOI: 10.1186/s12978-017-0411-5 |
| Pattinson, R.C., Bergh, A.M., Ameh, C., Makin, J., Pillay, Y., van den Broek, N. and Moodley, J., 2019. Reducing maternal deaths by skills-and-drills training in managing obstetric emergencies: A before-and-after observational study. South African Medical Journal, 109(4), pp.241-5. DOI:10.7196/SAMJ.2019.v109i4.13578 |
Prof Robert Pattinson was interviewed telephonically to elaborate further on this project. Prof Pattinson thanks Merck, Sharpe and Dohme (MSD) for the support that they have provided in this project. Download or listen to the interview here.
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