The Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis) study

APT-Sepsis is a carefully developed complex programme designed specifically to be used in countries and facilities where there are limited resources available. It aims to change healthcare workers’ behaviours to ensure mothers get the best care possible to better prevent and manage infections. The APT-Sepsis intervention brings together evidence-based practice to address these issues via an integrated program with 3 interventional domains and an implementation strategy. Domain one: ‘hand hygiene’, aims at ensuring compliance with the WHO 5 moments of hand hygiene.

Domain two:’infection prevention and management’,ensures the adoption of evidence-based practices for infection prevention in maternity, including appropriate antibiotic prophylaxis for high-risk women and improved surgical practices

Domain three: is the identification and treatment of sepsis.

We will evaluate if implementation of the APT- Sepsis programme is effective at reducing infection related maternal mortality and severe morbidity. We will also conduct a rigorous process evaluation to understand the implementation of the programme and will determine its cost effectiveness. This will be done to understand the implementation of APT-Sepsis and develop a longer-term implementation strategy. The study will be conducted for a period of 26 months, split into baseline, transition and intervention.

This is a cluster randomised study consisting of 60 hospitals in Malawi and Uganda. In Malawi the clusters are secondary level care hospitals which includes public district hospitals, and rural hospitals. We are in the districts of Karonga, Rumphi. Nkhata Bay, Mzimba, Kasungu, Nkhotakota, Salima, Ntchisi, Lilongwe, Mchinji, Dedza, Ntcheu, Balaka, Neno, Mwanza, Machinga, Mangochi, Zomba, Chiradzulu, Phalombe, Mulanje, Thyolo, Chikwawa and Nsanje.

Staff will benefit from increased training and knowledge in the prevention identification and treatment of APT-Sepsis. The patients they care for will be beneficiaries of this knowledge and it is our hope this will lead to improvements in the reduction of maternal mortality.