Scaling up Every Second Matters for Mothers and Babies - KetamineTM (ESM-KetamineTM)

Massachusetts General Hospital
Organization Location: 
Boston, MA, USA

Maternal and newborn death and disability due to obstructed labor and lack of access to manual vacuum aspiration and tubal ligation can be reduced with increased availability of surgical services. We propose to scale-up a best-evidence package on the use of ketamine anesthesia for emergency cesarean section, tubal ligation, and other painful reproductive procedures in Kenya (called Every Second Matters for Mothers and Babies - KetamineTM) (ESM-Ketamine). Our Transition to Scale proposal will provide the ESM-Ketamine package to 34 health facilities (covering a catchment area of nearly 6 million people). The package includes: an ESM-Ketamine kit, and a one-week training program for providers that covers basic pharmacology, appropriate monitoring, Helping Babies Breathe, wall charts and checklists, and case-based learning. The adoption of ESM-Ketamine in Kenya will avert many maternal and neonatal deaths. We anticipate that ESM-Ketamine will be scalable to other countries affected by the anesthesia gap, helping women receive essential surgical care. Finally, we believe that ESM-Ketamine will have ripple effects beyond reproductive health; it will increase poor communities’ access to a wide range of emergency care procedures. Standard practice in Kenya currently relies on the availability of an anesthetist to perform reproductive surgeries. Oftentimes, however, anesthetists are not available. ESM-Ketamine is a disruptive innovation that would markedly increase the availability of safe and carefully-bounded ketamine anesthesia for emergency cesarean section and painful procedures when no anesthetist is available.

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