MEPI-funded ESMOE activities 

South Africa has a high maternal mortality ratio compared to other mid-income countries with 23% of maternal deaths in KZN. One of the recommendations of the National Committee for Confidential Enquiries into Maternal Deaths was to improve and expand health worker training. The ESMOE program was designed in response to this, as a 12 module program to train Master Trainers with the knowledge and skills to appropriately manage obstetric emergencies.  

MEPI has funded the KZN strategy for ESMOE. Fourteen MEPI-funded 3-day ESMOE Master Trainer workshops have been held between 2011-2015 resulting in a total of 360 master trainers from all eleven districts of KZN and all levels of staff working in maternity units such that each facility has at least two ESMOE master trainers, one doctor and one midwife, as part of their staff. 


Targeted health professionals for ESMOE training include: 

  • Obstetrician specialists
  • Family Medicine specialists with an interest in maternity work
  • Clinical and experienced Managers/medical officers of maternity at District Hospitals
  • Operational managers (midwives in charge) in the labour wards of hospitals or midwife-run obstetric units.



Preliminary data from the ESMOE summative evaluation shows that majority of Master Trainers who have thus far responded to the survey believe the master trainer program has given them full competency to conduct master trainings in their facilities in 12 domains of obstetric emergencies.  Majority of them have started to implement fire drills in their facilities and do so at least once a month with midwives, various categories of nurses and medical officers.  Data collection is still underway and the final analyses may reveal the impact of the ESMOE program across the KZN province.

The evidence from the latest Saving Mothers report on maternal mortality in KZN demonstrates a steady decline each year which coincides with the introduction of ESMOE in 2009, and the scaling-up of the ESMOE through the MEPI workshops since 2011. 

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