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CONFERENCE PROCEEDING
Frequency of team-simulation and reduction in maternal deaths following Safer Births Bundle of Care implementation – A prospective observational study
1
SAFER simulation center, External training programs, Stavanger, Norway
2
Muhimbili University of Health and Allied Sciences, School of Public Health, Dar es Salaam, Tanzania- United Republic of
3
Haydom Lutheran Hospital, Research department, Haydom, Tanzania- United Republic of
4
Muhimbili University of Health and Allied Sciences, Department of Paediatrics and Child Health, Dar es Salaam, Tanzania- United Republic of
5
Copenhagen Academy of Medical Education and Simulation, n/a, Copenhagen, Denmark
6
The University of Stavanger, Department of Mathematics and Physics, Stavanger, Norway
7
Stavanger Univsersity Hospital, Department of Simulation-based Learning, Stavanger, Norway
Eur J Midwifery 2026;10(Supplement 1):A219
ABSTRACT
BACKGROUND:
The Safer Births Bundle of Care (SBBC) is a continuous quality improvement (CQI) program implemented in 30 health facilities across Tanzania. The project main report documented a 75% reduction in maternal deaths. Simulation training was integrated as part of the CQI strategy, targeting identified clinical gaps in both individual and team-based care.
OBJECTIVES:
To examine the frequency of documented simulation sessions, number of recurring participants, and associations with changes in maternal mortality.
METHODS:
SBBC was designed as a stepped-wedge cluster randomized implementation trial across 30 facilities in five Tanzanian regions between 2020 and 2023. The SimBegin® facilitator training program was used to establish a sustainable training cascade. A total of 90 healthcare workers were trained through three levels: facilitators (Level 1), mentors (Level 2), and instructors (Level 3). These local facilitators led simulations, reviewed clinical data, and maintained detailed training logs. Clinical outcome data were independently collected from patient files and fed back weekly to guide targeted training efforts. Key measures included simulation frequency, number of recurring participants, and maternal deaths within seven days postpartum in the subsequent month.
RESULTS:
The study included 281,165 parturient women. A total of 1,280 simulation sessions were documented during the project period. We demonstrated a significant increase in simulation activities following the respective SimBegin levels (p<0.001). Higher simulation frequency (P=0.0018) and increased number of participants (P=0.0006) was associated reduction in maternal deaths the subsequent month.
CONCLUSIONS:
Implementation of simulation-based training through the SimBegin® program was associated with a substantial reduction in maternal deaths. Increased frequency of simulations and participation by recurring participants appear to be key drivers of this improvement.
KEY MESSAGE:
Regular, structured simulation training can be a powerful tool to reduce maternal mortality in low-resource settings Abuse - domestic violence
The Safer Births Bundle of Care (SBBC) is a continuous quality improvement (CQI) program implemented in 30 health facilities across Tanzania. The project main report documented a 75% reduction in maternal deaths. Simulation training was integrated as part of the CQI strategy, targeting identified clinical gaps in both individual and team-based care.
OBJECTIVES:
To examine the frequency of documented simulation sessions, number of recurring participants, and associations with changes in maternal mortality.
METHODS:
SBBC was designed as a stepped-wedge cluster randomized implementation trial across 30 facilities in five Tanzanian regions between 2020 and 2023. The SimBegin® facilitator training program was used to establish a sustainable training cascade. A total of 90 healthcare workers were trained through three levels: facilitators (Level 1), mentors (Level 2), and instructors (Level 3). These local facilitators led simulations, reviewed clinical data, and maintained detailed training logs. Clinical outcome data were independently collected from patient files and fed back weekly to guide targeted training efforts. Key measures included simulation frequency, number of recurring participants, and maternal deaths within seven days postpartum in the subsequent month.
RESULTS:
The study included 281,165 parturient women. A total of 1,280 simulation sessions were documented during the project period. We demonstrated a significant increase in simulation activities following the respective SimBegin levels (p<0.001). Higher simulation frequency (P=0.0018) and increased number of participants (P=0.0006) was associated reduction in maternal deaths the subsequent month.
CONCLUSIONS:
Implementation of simulation-based training through the SimBegin® program was associated with a substantial reduction in maternal deaths. Increased frequency of simulations and participation by recurring participants appear to be key drivers of this improvement.
KEY MESSAGE:
Regular, structured simulation training can be a powerful tool to reduce maternal mortality in low-resource settings Abuse - domestic violence
| eISSN: | 2585-2906 |
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