Obstetric First Responders in Chiapas: innovative trainings by PACE-MD

We have been following PACE-MD with great interest for years now. They focus on Obstetrical First Responders as the first link in the chain of survival in Mexico. We have long believed that the analogy to an EMT might be a better way to get beyond the long-standing disputes over what traditional birth attendants versus midwives versus others, including community health workers, can handle as far as maternal health emergencies. PACE-MD focuses on handling obstetric emergencies starting at the first contact with a health worker.

Through this successful model of community oriented, manikin based simulation, mnemonics (¨ABCs¨), and competency based certified SKILLS courses, PACE has trained and certified almost 20,000 health providers in various emergency conditions. Let us repeat: 20,000 health workers. This includes over 8,000 health providers in emergency obstetrics (through the Advanced Life Support in Obstetrics program-- ALSO) in underserved urban and rural communities throughout Mexico. What we like about this model is that it builds on the health providers who are already working on the frontlines, honing skills and building capacity to respond to obstetric and neonatal emergencies. PACE MD’s workshops in Mexico include Vacuum Assisted Delivery, “FAST OB” Ultrasound and Neonatal Resuscitation, and other basic and advanced surgical workshops. ALSO training finishes with a “Mega Delivery” Stress Test, something that every midwife, obstetrician and obstetric team should certainly be expected to pass.

The courses tend to have most or all of the following characteristics:

-They are highly regimented, reproducible and scalable.

-They are short courses that are ¨hands on¨, using manikin simulation

-They use “Best Practice and Evidenced Based” protocols, and use mnemonics to aid in memorization of core skills.

-They train midwives and community health workers together as a team. They also train primary care clinicians and obstetricians

PACE-MD reports that the certification cards received upon successful completion of the courses are highly coveted and can only be provided by designated training centers, and not instructors. The certification cards typically expire in two years, requiring refresher courses or recertification.

The team placed as a runner up in the William James Foundation / Mentor Capital Network social enterprise competition. They also won the I3LATAM which is a terrific honor. As a result, [PACE-MD was voted one of the top 10 Social Entrepreneurs in Latin America](https://www.indiegogo.com/projects/pace-md-global-health-in-action)!

The PACE-MD team integrates "Helping Babies Breathe" curriculum into their work, and they fold in mHealth as well. The mHealth protocol for midwives is a two button entry in their phone that sends an Obstetrical Emergency Alert message up the chain of survival. The certification means that they are a recognized health care worker.

The PACE-MD solution is one that builds upon the existing health system in a unique and efficient way. We can't wait to tell you more.