Background & Aims
In the tumultuous economic landscape of 2022 and 2023, this explores the groundbreaking initiative of establishing a labor epidural service in a resource-limited rural hospital in Sri Lanka. Labor epidurals, considered the gold standard for pain management during childbirth, were sparingly utilized in the country, with accessibility confined to tertiary hospitals. The economic and fuel crisis compounded existing challenges, introducing formidable barriers such as a scarcity of epidural kits, essential medications, and a critical shortage of anesthesia professionals.
Methods
Navigating these challenges required ingenuity and resourcefulness. Leveraging donated materials and government-provided PCA pumps became a cornerstone of our strategy. Education emerged as a linchpin, necessitating comprehensive workshops for midwives, nurses, and medical officers. These sessions dispelled prevailing myths and cultivated a nuanced understanding of the multifaceted benefits of labor epidurals. A meticulously crafted guideline, covering indications, contraindications, drug usage, troubleshooting, and protocols for patients in the theatre, became our roadmap.
Results
Overcoming initial skepticism and reluctance was no small feat. A multi-pronged approach to securing patient consent proved effective, incorporating multilingual consent forms, informative leaflets, targeted antenatal clinic sessions, vivid posters, educational videos, newspaper articles, and a book written in Sinhala. Commencing with a modest 1-2 cases daily, our data collection reflected a steady increase in patient satisfaction. Media involvement, including the provision of voice cuts, played a crucial role in fostering awareness within the hospital’s catchment area. Yet, persistent challenges persisted, limiting the service to specific hours due to a pronounced shortage of anesthesiologists.
Conclusions
This study underscores the feasibility of implementing a labor epidural service in a rural setting during an economic crisis. The amalgamation of strategic planning, community engagement, and innovative education initiatives proved pivotal in overcoming multifaceted barriers. The findings accentuate the importance of bridging accessibility gaps and dispelling misconceptions, positioning labor epidurals as an integral facet of enhanced maternal care and transformative birthing experiences.
References
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2.Luft HS. Economic incentives to promote innovation in healthcare delivery. Clin Orthop Relat Res. 2009 Oct;467(10):2497-505. doi: 10.1007/s11999-009-0930-7. Epub 2009 Jun 19. PMID: 19543780; PMCID: PMC2745468.
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Presenting Author
Roshana Mallawaarachchi
Poster Authors
Topics
- Access to Care