Background: Stillbirths and neonatal deaths are devastating events for both parents and clinicians and are global\npublic health concerns. Careful clinical management after these deaths is required, including appropriate investigation\nand assessment to determine cause (s) to prevent future losses, and to improve bereavement care for families. An\neducational programme for health care professionals working in maternal and child health has been designed to address\nthese needs according to the Perinatal Society of Australia and New Zealand Guideline for Perinatal Mortality: IMproving\nPerinatal mortality Review and Outcomes Via Education (IMPROVE). The programme has a major focus on stillbirth\nand is delivered as six interactive skills-based stations. We aimed to determine participants� pre- and post-programme\nknowledge of and confidence in the management of perinatal deaths, along with satisfaction with the programme.\nWe also aimed to determine suitability for international use.\nMethods: The IMPROVE programme was delivered to health professionals in maternity hospitals in all seven Australian\nstates and territories and modified for use internationally with piloting in Vietnam, Fiji, and the Netherlands (with the\nassistance of the International Stillbirth Alliance, ISA). Modifications were made to programme materials in consultation\nwith local teams and included translation for the Vietnam programme. Participants completed pre- and post-programme\nevaluation questionnaires on knowledge and confidence on six key components of perinatal death management as well\nas a satisfaction questionnaire.\nResults: Over the period May 2012 to May 2015, 30 IMPROVE workshops were conducted, including 26 with 758\nparticipants in Australia and four with 136 participants internationally. Evaluations showed a significant improvement\nbetween pre- and post-programme knowledge and confidence in all six stations and overall, and a high degree of\nsatisfaction in all settings.\nConclusions: The IMPROVE programme has been well received in Australia and in three different international settings\nand is now being made available through ISA. Future research is required to determine whether the immediate\nimprovements in knowledge are sustained with less causes of death being classified as unknown, changes in clinical\npractice and improvement in parents� experiences with care. The suitability for this programme in low-income countries\nalso needs to be established
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