PROMPT Training in Zimbabwe

Since it's development in 2002, the PROMPT course and it's underlying principles of local training with full involvement of the multi-professional team have been widely adopted in the UK and other countries across the world.

The maternal mortality rate in Zimbabwe had increased from 555 to 960 per 100,000 live births between 2006 and 2011. Furthermore a national review identified 47% of maternal deaths as avoidable.  PROMPT was first implemented in Zimbabwe at Mpilo Central Hospital, Bulawayo in 2011.  A visiting multi-professional tam delivered a three day 'Train the Trainers (T3) programme to a small group of local staff, consisting of midwifery matrons, midwives and doctors.  The programme included a demonstration of the PROMPT course, training in adapting and delivering a local PROMPT course and finally, supporting the local staff in running their local training for their fellow colleagues.

The Zimbabwean team were provided with all the resources that were required to continue running the training, local staff introduced a board to provide an overview of patients on the labour ward.  Local staff also adapted a maternity early warning score chart and monitored its effectiveness with monthly post audits.  A maternity dashboard was developed and completed monthly by the Reproductive Health Officer to enable local monitoring of clinical outcomes. 

Within the first 12 months, 90% of staff working in the maternity unit had attended a PROMPT training day run within their hospital and facilitated by local staff.  The maternity dashboard allowed the staff to take responsibility for local outcomes and promoted a positive attitude towards improvements in patient care.  It also enabled the PROMPT trainers to be locally responsive and and focus training on where it was needed most. Since the introduction of PROMPT and its safety tools, the maternal mortality rate at Mpilo Central Hospital decreased by 34%.  In 2011 there were 67 maternal deaths and 9078 live births a Mpilo, b y 2014 this had reduced to 48 maternal deaths with 9884 live births.

The successful implementation of PROMPT at Mpilo Central Hospital has led to demand for PROMPT training in other hospitals in Zimbabwe.  St Patricks Hospital, Hwange and St Lukes Hospital, Centenary District, commenced PROMPT training in March 2014 and June 2015 respectively.  Staff from Mpilo travelled to these distant units to help local staff establish their own training.  The success of the training in Zimbabwe has led to a programme of roll-out of PROMPT training to 56 health facilities managed by the Zimbabwe Catholic Bishops Conference. 

The key to success of this project has ben the partnership between clinicians in Zimbabwe (seven of whom have travelled to the UK on partnership visits), Zimbabwean diaspora within the UK and the UK PROMPT team based at North Bristol NHS Trust.  The enthusiasm and hard work of our Zimbabwean colleagues has enabled PROMPT training to be adapted into locally relevant and effective safety tools.

The Partnership would like to thank the Tropical Health and Education Trust (THET) and the Department for International Development (DfID) for their continuing support of this project.