Charles Ameh

Charles Ameh
Liverpool School of Tropical Medicine · Maternal and Newborn Health Unit

PhD

About

89
Publications
54,742
Reads
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1,563
Citations
Introduction
Charles Ameh heads the Emergency Obstetric Care and Quality of Care unit, Department of International Public Health, Liverpool School of Tropical Medicine. Charles does research in Maternal Health specifically training, capacity building, Emergency Obstetric Care, Maternal Death Surveillance and Response, Confidential Enquiry into Maternal Deaths. Their current research in Sierra Leone, Nigeria and Kenya.
Additional affiliations
March 2007 - October 2016
Liverpool School of Tropical Medicine
Position
  • Lecturer
March 2007 - present
Liverpool School of Tropical Medicine
Position
  • Lecturer
Description
  • Research, Education, Technical assistance
January 2000 - March 2006
Ahmadu Bello University
Position
  • Obstetrician and Gynaecologist
Education
July 2010 - December 2014
University of Liverpool
Field of study
  • Maternal and Newborn Health
May 2007 - July 2009
University of Liverpool
Field of study
  • Public Health
April 2006 - June 2006
Liverpool School of Tropical Medicine
Field of study
  • Reproductive Health

Publications

Publications (89)
Preprint
Full-text available
Background International Confederation of Midwives and World Health Organization recommend core competencies for midwifery educators for effective theory and practical teaching and practice. Deficient curricula and lack of skilled midwifery educators are important factors affecting the quality of graduates from midwifery programmes. The study objec...
Article
Obstetric Early Warning Systems (EWS) use combined clinical observations to predict increased risk of deterioration and alert health workers to institute actions likely to improve outcomes. The objective of this study was to explore the experience of health workers about the implementation of an obstetric EWS and assess its effectiveness as an alte...
Article
Full-text available
Introduction: Kenya's maternal mortality ratio is relatively high at 342/100,000 live births. Confidential enquiry into maternal deaths showed that 90% of the maternal deaths received substandard care with health workforce related factors identified in 75% of 2015/2016 maternal deaths. Competent Skilled Health Personnel (SHP) providing emergency o...
Conference Paper
E P. 0 5 4 1| It’s complicated...: Views of clinicians in Kenya on assisted vaginal births Fiona Dickinson 1; Helen Allott 1; Paul Nyongesa 2; Ch Moi University, Eldoret, Kenya Objective: To explore the views of clinicians and managers in five counties in Kenya, regarding assisted vaginal birth- (AVB) and reasons for non- performance.Design: Quali...
Article
Introduction Provision of emergency obstetric and newborn care (EmONC) by skilled health personnel reduces maternal and newborn mortality. Pre-service diploma midwifery and clinical medicine (reproductive health) curricula in Kenya were reviewed and updated integrating the competency based EmONC curriculum. A two-part (virtual for theoretical compo...
Article
Reducing the risk of death from PPH requires evidence‐based care, innovations, and addressing demand and supply‐side bottlenecks around quality, availability, and use of uterotonics.
Article
Full-text available
Introduction Prompt access to emergency obstetrical care (EmOC) reduces the risk of maternal mortality. We assessed institutional maternal mortality by distance and travel time for pregnant women with obstetrical emergencies in Lagos State, Nigeria. Methods We conducted a facility-based retrospective cohort study across 24 public hospitals in Lago...
Article
Full-text available
Globally, low and middle-income countries bear the greatest burden of maternal and newborn mortality. To reduce these high levels, the quality of care provided needs to be improved. This study aimed to develop a patient reported outcome measure for use in maternity services in low and middle-income countries, to facilitate improvements in quality o...
Article
Obstetric and gynaecology undergraduate training is an intense time for learners as they encounter various health conditions related to women’s health and also learn about pregnancy care and birth. The experience is directed to familiarise students with basic clinical management of gynaecological conditions, also develop communication and related c...
Article
Full-text available
Background: This paper presents a descriptive analysis of the perceptions of Kenyan midwifery educators regarding the early impact of coronavirus disease 2019 (COVID-19) on the continuity of midwifery education. Methods: A cross-sectional online survey was conducted among 51 midwifery/clinical medicine educators from 35 diploma training colleges...
Preprint
Full-text available
Introduction Kenya’s maternal mortality ratio is relatively high at 342/100,000 live births. Confidential enquiry into maternal deaths showed that 90% of the maternal deaths received substandard care with health workforce related factors identified in 75% of 2015/2016 maternal deaths. Competent Skilled Health Personnel (SHP) providing emergency obs...
Article
Full-text available
The global COVID-19 pandemic is predicted to compromise the achievement of global reproductive, maternal , and newborn health (RMNH) targets. The objective of this study was to determine the health facility (HF) preparedness for RMNH service delivery during the outbreak from the perspective of RMNH providers and to determine what factors significan...
Article
Full-text available
Objective: To estimate utilization costs of spontaneous vaginal delivery (SVD) and cesarean delivery (CD) for pregnant women with coronavirus disease 2019 (COVID-19) at the largest teaching hospital in Lagos, the pandemic's epicenter in Nigeria. Methods: We collected facility-based and household costs of all nine pregnant women with COVID-19 manage...
Preprint
Full-text available
Background Obstetric Early Warning Systems (EWS) use combined clinical observations to predict increased risk of deterioration and alert health workers to institute actions likely to improve outcomes. The objective of this study was to assess the effectiveness of a validated obstetric EWS in improving health outcomes and explore the experience of h...
Article
Objective To estimate utilization cost of spontaneous vaginal delivery (SVD) and caesarean delivery (CD) for pregnant women with Coronavirus Disease (COVID‐19) at the largest teaching hospital in Lagos, the pandemic’s epicenter in Nigeria. Methods We collected facility‐based and household costs of all nine pregnant women with COVID‐19 managed at t...
Preprint
Full-text available
The Coronavirus disease 2019 (COVID-19) has been a major disruptor of health systems globally. Its emergence has warranted the need to reorganize maternity services for childbirth. However, it is not known if this comes at an additional cost to women. We conducted a hospital-based cost analysis to estimate the out-of-pocket cost of spontaneous vagi...
Preprint
Full-text available
The global COVID-19 pandemic is predicted to compromise the achievement of global reproductive, maternal and newborn health (RMNH) targets. The objective of this study was to determine the health facility (HF) preparedness for RMNH service delivery during the outbreak from the perspective of RMNH providers and to determine what factors significantl...
Preprint
Full-text available
Background Obstetric Early Warning Systems (EWS) use combined clinical observations to predict increased risk of deterioration and alert health workers to institute actions likely to improve outcomes. The objective of this study was to explore the experience of health workers and managers who implemented a low resource setting specific statisticall...
Article
Full-text available
Background The COVID-19 global pandemic is expected to result in 8.3–38.6% additional maternal deaths in many low-income countries. The objective of this paper was to determine the initial impact of COVID-19 pandemic on reproductive, maternal, newborn, child and adolescent health (RMNCAH) services in Kenya. Methods Data for the first four months (...
Article
Full-text available
Background: The use of obstetric early-warning-systems (EWS) has been recommended to improve timely recognition, management and early referral of women who have or are developing a critical illness. Development of such prediction models should involve a statistical combination of predictor clinical observations into a multivariable model which sho...
Preprint
Full-text available
Background Obstetric Early Warning Systems (EWS) use combined clinical observations to predict increased risk of deterioration and alert health workers to institute actions likely to improve outcomes. The objective of this study was to assess the effectiveness of a validated obstetric EWS in improving health outcomes and explore the experience of h...
Preprint
Full-text available
Background The use of obstetric early warning systems (EWS) has been recommended to improve timely recognition, management and early referral of women who have or are developing a critical illness. Development of such prediction models should involve a statistical combination of predictor clinical observations into a multivariable model which shoul...
Article
Full-text available
Introduction Maternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective. Methods We searched multiple peer-reviewed databases (including Africa...
Article
Full-text available
Background: Cost is a major barrier to maternal health service utilisation for many women in low- and middle-income countries (LMICs). However, comparable evidence of the available cost data in these countries is limited. We conducted a systematic review and comparative analysis of costs of utilising maternal health services in these settings. Me...
Article
Full-text available
Introduction: Two-thirds of maternal deaths and 40% of intrapartum-related neonatal deaths are thought to be preventable through emergency obstetric and newborn care (EmOC&NC). The effectiveness of 'skills and drills' training of maternity staff in EmOC&NC was evaluated. Methods: Implementation research using a stepped wedge cluster randomised t...
Article
Full-text available
Introduction: There is substantial evidence that maternal health services across the continuum of care are effective in reducing morbidities and mortalities associated with pregnancy and childbirth. There is also consensus regarding the need to invest in the delivery of these services towards the global goal of achieving Universal Health Coverage...
Article
Full-text available
Introduction Several versions of Early Warning Systems (EWS) are used in obstetrics to detect and treat early clinical deterioration to avert morbidity and mortality. EWS can potentially be useful to improve the quality of care and reduce the risk of maternal mortality in resource-limited settings. We conducted a systematic literature review of pub...
Article
Full-text available
Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the evidence for the effectiveness of tra...
Article
Full-text available
Background: The institutional maternal mortality ratio (iMMR) in South Africa (SA) is still unacceptably high. A key recommendation from the National Committee on Confidential Enquiries into Maternal Deaths has been to improve the availability and quality of care for women suffering obstetric emergencies. Objectives: To determine whether there w...
Article
Full-text available
Background: This study explores stakeholders' perceptions of emergency obstetric care (EmOC) 'skills-and-drills'-type training including the outcomes, strengths, weaknesses, opportunities and threats of the intervention in Kenya. Methods: Stakeholders who either benefited from or contributed to EmOC training were purposively sampled. Semi-struct...
Poster
Full-text available
The partograph is a useful tool for improving the quality of care during labour (pictorial overview of labour progress, clinical audit, training of health care workers and facilitating the transfer of care). The WHO recommends its use especially in under-resourced settings. Several studies have reported under-utilization of the partograph in such s...
Article
Full-text available
Objective To determine retention of knowledge and skills after standardised “skills and drills” training in Emergency Obstetric Care. Design Longitudinal cohort study. Setting Ghana, Malawi, Nigeria, Kenya, Tanzania and Sierra Leone. Population 609 maternity care providers, of whom 455 were nurse/midwives (NMWs) Methods Knowledge and skills ass...
Data
Fitted models for knowledge relative change scores for nurse-midwives, by country. (DOCX)
Data
Fitted models for skills relative change scores for nurse-midwives, by country. (DOCX)
Article
Full-text available
Background: Poor emergency obstetric care has been shown by national confidential enquiries into maternal deaths to contribute to a number of maternal deaths in South Africa. Objectives: To assess whether a structured training course can improve knowledge and skills and whether this can influence the capacity of a healthcare facility to provide...
Article
Full-text available
Background: Maternal and Child Health Aides are the largest nursing cadre in Sierra Leone providing maternal and child health care at primary level. Poor healthcare infrastructure and persistent shortage of suitably qualified health care workers have contributed to high maternal and newborn morbidity and mortality. In 2012, 50% of the MCHAides coh...
Article
Full-text available
Maternal death surveillance and response (MDSR) constitutes a quality improvement approach to identify how many maternal deaths occur, what the underlying causes of death and associated factors are, and how to implement actions to reduce the number of preventable stillbirths and maternal and neonatal deaths. This requires a coordinated approach, en...
Article
Full-text available
Background Maternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify l...
Article
Full-text available
Responding to increasing demands to demonstrate value-for-money (VfM) for maternal and newborn health interventions, and in the absence of VfM analysis in peer-reviewed literature, this paper reviews VfM components and methods, critiques their applicability, strengths and weakness and proposes how VfM assessments can be improved. VfM comprises four...
Article
Full-text available
Objective To explore nurse-midwives understanding of their role in and ability to continue to provide routine and emergency maternity services during the time of the Ebola virus disease epidemic in Sierra Leone. Design A hermenuetic phenomenological approach was used to discover the lived experiences of nurse-midwives through 66 face to face inter...
Article
Full-text available
Background Adolescent mothers aged 15–19 years are known to have greater risks of maternal morbidity and mortality compared with women aged 20–24 years, mostly due to their unique biological, sociological and economic status. Nowhere Is the burden of disease greater than in low-and middle-income countries (LMICs). Understanding factors that influen...
Article
Background: Kenya has one of the highest adolescent fertility rates in East-Africa, estimated at 106 births per 1000 females aged 15-19years. In addition to promoting safe sexual behaviour, utilisation of maternal health services (MHS) is essential to prevent poor outcomes of pregnancy and childbirth. To ensure optimum planning, particularly in th...
Article
Full-text available
Background: Healthcare provider training in Emergency Obstetric and Newborn Care (EmOC&NC) is a component of 65% of intervention programs aimed at reducing maternal and newborn mortality and morbidity. It is important to evaluate the effectiveness of this. Methods: We evaluated knowledge and skills among 5,939 healthcare providers before and aft...
Data
Data File: Knowledge and Skills Testing Results (SAV)
Article
Full-text available
Background: The high maternal mortality rate in Sierra Leone combined with an ongoing shortage of midwives has led to the introduction of new cadres of healthcare workers. Maternal and Child Health Aides are one such cadre and now provide 56% of patient care. The quality of the education training programme for MCHA is therefore of paramount import...
Article
Background Many Kenyan adolescents die following pregnancy and childbirth complications. Maternal health services (MHS) utilisation is key to averting such poor outcomes. Our objectives were to understand the characteristics of adolescent mothers in Kenya, describe their MHS utilisation pattern and explore factors that influence this pattern. Meth...
Article
Full-text available
Objective: Maternal and Child Health Aides (MCH Aide) in Sierra Leone provide the majority of maternity services at primary care level. To formulate recommendations for improving the quality and scale-up of MCH Aides training an evaluation of all schools across Sierra Leone was undertaken. Design: structured, direct observation of two randomly s...
Article
Full-text available
Increased scarcity of public resources has led to a concomitant drive to account for value-for-money of interventions. Traditionally, cost-effectiveness, cost-utility and cost-benefit analyses have been used to assess value-for-money of public health interventions. The social return on investment (SROI) methodology has capacity to measure broader s...
Article
Full-text available
An estimated 289,000 maternal deaths, 2.6 million stillbirths and 2.4 million newborn deaths occur globally each year, with the majority occurring around the time of childbirth. The medical and surgical interventions to prevent this loss of life are known, and most maternal and newborn deaths are in principle preventable. There is a need to build t...
Article
Maternal death review (MDR) is an accepted process that is implemented across Malawi and 'underlying cause of death' is assigned by healthcare providers using a standard MDR form. Mixed-methods approach. Key informant interviews with eight stakeholders involved in MDR. Secondary analysis of MDR forms for 54 maternal deaths. Comparison of assigned c...
Article
Understanding the causes of and factors contributing to maternal deaths is critically important for development of interventions that reduce the global burden of maternal mortality and morbidity. The International Classification of Diseases-Maternal Mortality (ICD-MM) classification of cause of death during pregnancy, childbirth and the puerperium...
Article
Full-text available
Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not facilitate their involvement. This qualitative st...