AFJOG

African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | 42 African Journal of Obstetrics and Gynaecology | Volume 2 | Issue 2 | 2024 | Abstracts AFJOG ABSTRACTS ABSTRACTTITLE: 74: The Perinatal Mental Health Project (PMHP) multi- component service model – addressing challenges of implementation in Cape Town AUTHORS: Prof Simone Honikman simone.honikman@uct.ac.za Simone Honikman 1 , Liesl Hermanus 1 , Tyla Prinsloo 1 , Siphumelele Sigwebela 1 , Thanya April 1 1 Perinatal Mental Health Project, Centre for Public Mental Health. Department of Psychiatry and Mental Health, University of Cape Town Introduction: In South Africa, the prevalence of common perinatal mental disorders is high. With a substantial uptake of maternity services by pregnant women, these facilities offer a vital opportunity for integrated mental healthcare delivery. This study aims to elucidate the components of the current PMHP maternal support service model, implemented at a Midwife Obstetric Unit (MOU) in Cape Town. We will underscore adaptations made to address real-world challenges and existing opportunities that were leveraged. The new National Maternity Care Guidelines due for publication this year will include a new chapter on maternal mental health. This presentation describes a model that implements this guidance. Methods: We describe each element of the service model, describing iterative changes made over time. Additionally, we present service indicators, including outcomes data from the year 2023. Results: To enhance operational efficiency and client engagement, the service model has evolved to include the following elements: 1) collaboration with maternity staff, 2) mental health Promotion, Prevention, and service Preparedness (PPP), 3) screening of select target groups utilizing a locally validated, ultra-brief tool, 4) Engagement Assessment and Triage (EAT) sessions, 5) provision of diverse psychotherapeutic and social support interventions tailored to individuals’ needs, 6) partnerships for case management, 7) monitoring and evaluation, and 8) staff wellbeing and supervision. In 2023, among 2010 women attending the MOU for their initial visit, 391 were identified as falling within target populations. Of these, 367 women underwent screening and an EAT session, with counselling offered to 340, of whom 292 accepted. A total of 240 new counselling clients received a mean of 3.8 sessions each. Of those counselled, 37.9%, 27.5%, and 34.6% required low, medium, and high intensity care, respectively. Sixty- seven women received a postnatal follow-up assessment, with 67% and 70% of presenting problems categorised as 'primary support' and 'mental health' reported as partially or completely resolved, respectively. Conclusion: The PMHP's mental health service model serves as a promising exemplar for the planning, organization, and integration of mental health services at the primary care level. ABSTRACTTITLE: 128: See one. .do one. .caesarean section teaching practices: A global survey AUTHORS: Dr Liesl de Waard ldewaard@sun.ac.za Liesl deWaard 1 , Kathryn Chu 2 , Elize Archer 3 , Stefan Gebhardt 4 1 Department of Obstetrics and Gynaecology, Stellenbosch University 2 Division of Global Surgery, Stellenbosch University, Cape Town 3 Division of Health Professions Education, Stellenbosch University, Cape Town 4 Department of Obstetrics and Gynaecology, Stellenbosch University Introduction: Caesarean section (CS) is the most common surgical procedure worldwide, performed by specialists, general doctors, and mid-level providers. Teaching of CS is not uniform, and this could affect patient outcomes. This study describes common CS teaching practices with a comparison between countries based on World Bank income designation. Methods: This was a cross-sectional descriptive study using a survey. General doctors and, Obstetricians and Gynaecologists were recruited at the FIGO (International Federation of Obstetrics and Gynaecology) conference in Paris 2023; a meeting of the World Association of Trainees in Obstetrics and Gynaecology; members of the South Africa Society of Obstetrics and Gynaecology and social-media platforms. Participation was anonymous and voluntary. Results: There were 411 participants from 42 countries with a median age of 38(IQR12). Most were specialists 214(52%) or trainees 107(41%) in obstetrics in gynaecology. The remainder were other specialists, trainees, medical officers or interns. Of the 411, 305 (74%) are performing CS independently, their median number performed per year is 58(IQR100), with 33(IQR50) in high-income countries(HIC) and 83(IQR140) in low and middle-income countries(LMIC). Two hundred and fifteen (60.2%) stated they had no formal training program for CS. Apprenticeship- based training was identified as the main training method for 309(85%), 47(11%) had presurgical training courses or modules and 19(4.6%) had training on simulators. Feedback on training was mostly informal for 264(74%) or for correction of technique 255(71%), while formal verbal feedback was utilised for training in 123(35%)- 78(19%) HIC and 45(10%) LMIC participants and formal written feedback in 53(15%) of which 42(10%) were participants in HIC and 11(3%) in LMIC. A large proportion, 139(42%) considered their training inadequate before performing CS independently. Regarding assessment of competence prior to performing CS independently , 131(31.87%) stated there was no formal, 156(37.96%) were assessed informally, formal structured assessments were used in 59(14%) participants, 38(9%) from HIC and 21(5%) LMIC. PLENARY SESSION ABSTRACTS: