An International Collaboration to Implement and Evaluate at Scale the Active Prevention and Treatment of Maternal Sepsis (APT-Sepsis Programme)

Lead Research Organisation: University of Liverpool
Department Name: Women's and Children's Health

Abstract

MATERNAL SEPSIS - AN URGENT RESEARCH NEED


"Maternal sepsis" is a life threatening condition caused by infection during or after pregnancy. It occurs if the body's response to a developing infection causes damage to its own organs. Maternal sepsis contributes to half of all maternal deaths. Internationally, organisations such as the World Health Organisation and United Nations are committed to reducing the numbers of women who die due to pregnancy and childbirth. Tackling maternal sepsis is an important part of this effort. However, there has been inadequate international focus on this issue, and there is an urgent need to identify effective ways to combat this problem.

A POTENTIAL SOLUTION

"The Active Prevention and Treatment of Maternal Sepsis" or APT-sepsis is a carefully developed programme designed specifically to be used in countries and facilities where there are limited resources available. It aims to change health care workers behaviours to ensure mothers get the best care possible to better prevent and manage infections.

In particular the programme will improve care by ensuring that health care workers: 1) always wash their hands to prevent the transmission of infections, 2) prevent infections by following all the World Health Organisation guidelines on infection prevention during pregnancy and birth 3) carry out regular vital sign monitoring and act rapidly to ensure women with suspected sepsis are given all the correct initial treatments using a specially developed maternal sepsis treatment "bundle".

This programme is based on an understanding that changing behaviours of health care workers required a carefully planned approach. Our approach helps provide the information, motivation and tools needed. This includes training delivered at the site, paper based checklists and reminders, a network of site champions who can help encourage change and provide ongoing feedback and coaching, involvement of the site management, re-organising sharing of tasks between staff and helping motivate sites and individuals.

WORK PREPARING FOR THE TRIAL

We have been working over several years with the World Health Organisation and healthcare workers in low resource countries to develop ATP-sepsis.

We have tested all parts of the programme in multiple hospitals and shown that it improves the quality of care given to women, and that it is acceptable and that change in practice can be maintained. However, to show that it improves the most important outcomes such as women dying or having very severe infections needs a large trial involving many centres and women and this is what we now plan to do.

THE APT-SEPSIS TRIAL

To carefully answer the question if the APT-sepsis programme reduces mothers dying or having the most severe infections will involve a clinical trial. This will be done in Malawi and Uganda.

We will work across 30 hospitals in each country. After a period where the outcomes will be carefully measured across all facilities, half of the hospitals will then test the APT-sepsis intervention and half will continue their usual practices. Which hospitals will use APT-sepsis will be decided by chance, but making sure that there is a balance in the facilities between both groups.

For the next 20 months we will then compare the outcomes in those hospitals taking part in APT-sepsis and those where usual practice is occurring. We will also look in detail at the way the programme is being carried out. This aspect will involve measuring what is happening at the facilities and also detailed interviews to understand the opinions of staff.

This research will tell us if the APT-sepsis programme can reduce bad outcomes and stop deaths from maternal sepsis in low resource settings. It will also help us understand how APT-sepsis is used in the study sites so that we can plan further implementation if it is shown to be useful. We also will discover if the APT-sepsis programme is cost effective.

Technical Summary

Objective:
Evaluate through a cluster randomised trial if implementation of the APT-sepsis programme reduces infection related maternal mortality and severe morbidity, evaluate implementation of the programme, and determine cost effectiveness.

Study Design:
Multi-country, parallel cluster randomised trial with baseline phase

Project duration:
42 months

Research location:
Malawi and Uganda

Population:
Clusters will be health care facilities managing > 1,500 births per year, offering comprehensive emergency obstetric care.
The primary outcome will be collected from all women who are admitted whilst pregnant or within 42 days of delivery.

Intervention:
APT-Sepsis is a complex intervention, developed to target care providers behaviours to improve adherence to best practice in 1) hand hygiene, 2) prevention and management of maternal infections 3) maternal sepsis management, including the FAST-M maternal sepsis bundle. It includes a carefully optimised set of implementation co-interventions to promote behaviour change.

Control:
Passive guidelines dissemination

Randomisation:
30 of the 60 health facilities will be randomly allocated to the intervention; minimisation for facility size, country and primary outcome baseline rate

Primary outcome:
The primary outcome is maternal infection related mortality and severe morbidity. This is a composite of infection related maternal mortality, infection related maternal near-miss or severe infection related morbidity (adapted CDC definition of deep surgical site infection or body cavity infection).

Implementation evaluation:
Mixed-methods evaluation will be undertaken to provide detailed understanding of the process of implementation, facilitate interpretation of trial outcomes and enable development of a longer-term implementation strategy.

Health economic evaluation:
Evaluate the cost effectiveness of the APT-sepsis intervention, from a provider perspective

Sample size:
172,500 births

Planned Impact

Mothers with sepsis: This research seeks to reduce death and severe morbidity due to sepsis that occurs during and after pregnancy, in low income countries, in particular Malawi and Uganda. We will seek to do this by introducing the APT-Sepsis programme. Women who are admitted to 30 health facilities in Malawi and Uganda, will directly benefit from the APT-sepsis programme. Which we anticipate will improve adherence to best practice in these facilities with improved hand hygiene, infection prevention and management, and sepsis detection and management, including the use of the FAST-M maternal sepsis bundle.
We will setup support groups for survivors of sepsis in Malawi and Uganda. These forums will provide women with support from a health-care professional and their peers. Members of these groups will also be given the opportunity to work with the study team to highlight this issue in their communities.

The wider public in Malawi and Uganda: The wider public will be actively engaged to participate in the study through patient and public involvement steering groups in each country. These groups will be asked to provide insights into the study processes to ensure that they are optimal for the setting. We will also have lay membership on the key trial steering committee. We will use social media and traditional media to also communicate about the issue of maternal infections and sepsis with the public.

The health care providers and health care systems: We hope that the engagement of health care facilities with this study will give providers additional training and understanding of how to better manage maternal sepsis. We anticipate that these benefits will last beyond the life of the trial itself.

Capacity building for researchers: We are working with the WHO HRP Alliance for Capacity Strengthening to provide opportunities for junior researchers from Malawi and Uganda to use this study as a platform to enhance their research skills and knowledge.

Policy change: To maximise the benefit from this research it is important that the findings inform policy, and can therefore impact on practice globally. We are working closely with the WHO who have a vital role in determining health care policy worldwide. We will also ensure that we collaborate with the ministries of health in Malawi and Uganda to inform them of the research findings and implications for care and other key international stakeholders such as the Global Sepsis Alliance, International Federation of Gynaecology and Obstetrics (FIGO), International Confederation of Midwives (ICM) and national professional organisations.
 
Title Maternal Sepsis: Working towards an end in Malawi 
Description Short film developed in collaboration with WHO. Filmed, edited and produced. 
Type Of Art Film/Video/Animation 
Year Produced 2023 
Impact Draws attention to maternal sepsis as a leading cause of death during or after pregnancy. 
URL https://www.youtube.com/watch?v=Tgo1XQW9Ye8
 
Title eCRF 
Description eCRF within RedCap 
Type Of Material Database/Collection of data 
Year Produced 2022 
Provided To Others? No  
Impact TBD 
 
Description Birmingham - Cost-effectiveness & sustainability of programme 
Organisation University of Birmingham
Country United Kingdom 
Sector Academic/University 
PI Contribution we provided data relevant to cost effectivenss and sustainability of the programme's delivery
Collaborator Contribution UoB will analyse the data
Impact None so far, analysis is ongoing but agreement reached
Start Year 2022
 
Description Malawi Ministry of Health - Zonal meeting CENTRAL EASTERN 13 January 2022 
Organisation Ministry of Health Malawi
Country Malawi 
Sector Public 
PI Contribution Presentation of study with support of MOH Representatives. In person presentation to potential participating sites.
Collaborator Contribution Representatives from the Ministry of Health and Apt-Sepsis researchers met with key stakeholders from the Zonal districts (Kasungu, Nkhotakota, Ntchisis, Dowa, Salima). Examples of attendees are: Director of Health and Social Services, (DHSS), District Medical officers, Safe motherhood coordinators, District Nursing Officers, safe motherhood coordinators, Zonal MDSR coordinators, Ministry of Health representatives, (Quality improvement and Reproductive health Directorates), APT-Sepsis co-ordinating team members.
Impact There are no set outputs yet as this meeting was for the sensitisation of potential project sites by sharing information and planning. Representatives from the attending districts helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones. The APT-Sepsis project is multi-disciplinary including healthcare professionals, healthcare managers, policy experts and key stakeholders in community organisations.
Start Year 2021
 
Description Malawi Ministry of Health - Zonal meeting CENTRAL WESTERN 14 January 2022 
Organisation Ministry of Health Malawi
Country Malawi 
Sector Public 
PI Contribution During this meeting the APT-Sepsis team presented the study aims and methods to potential participating sites.
Collaborator Contribution Representatives from the Ministry of Health and Apt-Sepsis researchers met with stakeholders from the Zonal districts (Lilongwe, Mchinji, Dedza, Ntchel). Examples of attendees are: Director of Health and Social Services, (DHSS), District Medical officers, Safe motherhood coordinators, District Nursing Officers, safe motherhood coordinators, Zonal MDSR coordinators, Ministry of Health representatives-(Quality improvement and Reproductive health Directorates), and APT-Sepsis co-ordinating team members.
Impact There are no set outputs yet as this meeting was for the sensitisation of potential project sites by sharing information and planning. Representatives from the attending district helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones. The APT-Sepsis collaboration is multi-disciplinary including healthcare professionals, healthcare managers, policy makers, and key stakeholders from community organisations.
Start Year 2021
 
Description Malawi Ministry of Health - Zonal meeting NORTH 11 January 2022 
Organisation Ministry of Health Malawi
Country Malawi 
Sector Public 
PI Contribution Presentation of study with support of MOH Representatives. In person presentation to potential participating sites.
Collaborator Contribution Representatives from the Ministry of Health and Apt-Sepsis researchers met with key stakeholders from the Zonal districts (Karonga, Chitipa, Nikhata Bay, Rumphi, Mzimba, Likoma Island). Examples of attendees are: Director of Health and Social Services, (DHSS) (formerly known as District Health officers-DHO), District Medical officers, Safe motherhood coordinators, Maternity Matrons, Ministry of Health representatives- (Quality improvement and Reproductive health Directorates, and APT-Sepsis co-ordinating team members.
Impact There are no set outputs yet as this meeting was for the sensitisation of potential project sites by sharing information and planning. Representatives from the attending districts helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones. The APT-Sepsis project is multi-disciplinary including healthcare professionals, healthcare managers, policy experts and key stakeholders in community organisations.
Start Year 2021
 
Description Malawi Ministry of Health - Zonal meeting SOUTH EASTERN 18 January 2022 
Organisation Ministry of Health Malawi
Country Malawi 
Sector Public 
PI Contribution During these in person meetings the APT-Sepsis team presented the study aims and methods to MOH Representatives and others at a potential participating site.
Collaborator Contribution Representatives from the Ministry of Health and Apt-Sepsis researchers met with key stakeholders from the Zonal districts (Mangochi, Balaka, Zomba, Mulanje, Phalombe, Machingal). Examples of attendees are: Director of Health and Social Services, (DHSS), District Medical officers, Safe motherhood coordinators, District Nursing Officers, safe motherhood coordinators, Zonal MDSR coordinators, Ministry of Health representatives-(Quality improvement and Reproductive health Directorates), APT-Sepsis co-ordinating team members.
Impact There are no set outputs yet as this meeting was for the sensitisation of potential project sites by sharing information and planning. Representatives from the attending districts helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones. The purpose of this meeting was to inform potential study sites of the project activities and to enlist local government support. The APT-Sepsis collaboration is multidisciplinary including healthcare professionals, policy experts, healthcare managers and key stakeholders from community organisations.
Start Year 2021
 
Description Malawi Ministry of Health - Zonal meeting SOUTH WESTERN 19 January 2022 
Organisation Ministry of Health Malawi
Country Malawi 
Sector Public 
PI Contribution During this information and planning meeting the APT-Sepsis team met with MOH representatives at potential participating sites.
Collaborator Contribution Representatives from the Ministry of Health attended with stakeholders from the Zonal districts (Blantyre, Chiadzulu, Thyolo, Neno, Mwanza, Chikhwawa, and Nsanje) to facilitate understanding of Apt-Sepsis and endorse participation in the project. Examples of attendees are: Director of Health and Social Services, (DHSS), District Medical officers, Safe motherhood coordinators, District Nursing Officers, Chief Nursing officer and the Director from Queen Elizabeth Central Hospital, Safe motherhood coordinators, Zonal MDSR coordinators, Ministry of Health representatives-(Quality improvement and Reproductive health Directorates), and APT-Sepsis co-ordinating team members.
Impact There are no set outputs yet as this meeting was for the sensitisation of potential project sites by sharing information and planning. Representatives from the attending district helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones. The Apt-Sepsis project is multi-disciplinary including healthcare professionals, healthcare managers, policy experts and key stakeholders in community organisations.
Start Year 2021
 
Description UCL - Analysis of 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Provided data from online surveys for analysis by UCL
Collaborator Contribution UCL doing the analysis and not currently held on LCTC servers. Analysis of data provided from online survey data. Building a model to implement process evaluations for behaviour change during interventions.
Impact Drafted protocol for process evaluation and draft model for how to evaluate it
Start Year 2023
 
Description Uganda Ministry of Health 13 January 2022 
Organisation Ministry of Health, Uganda
Country Uganda 
Sector Public 
PI Contribution The purpose of the online meeting was to explain the APT-Sepsis programme to the Director of Health Services with the aim to strengthen Maternal services in Uganda and to obtain support.
Collaborator Contribution Representatives from the Ministry of Health and Apt-Sepsis researchers met to facilitate joint understanding of Apt-Sepsis aims and methods, and to endorse participation in the project. Those attending this informational and planning meeting included: Dr Charles Olaro Director Health Services, Ministry of Health (MoH) Uganda, Prof David Lissauer Lead investigator university of Liverpool based in Malawi, Dr Catriona Waitt, Pharmacologist University of Liverpool and IDI Uganda, Judith Nanyondo Project Manager IDI Uganda, Principal investigator Mohammed Lamorde Director IDI Uganda, Sonia Whyte (SW) Senior Trial Manager, University of Liverpool, UK.
Impact This meeting was an initial information and planning meeting to enlist local government support in Uganda. The Ministry of Health endorsed the project and helped identify potential participating study sites. The Ministry of Health agreed that the project met many of the goals they had already identified for ongoing quality improvement work, including reduction of maternal sepsis. The MOH are pleased to offer support to the project which is ideal for implementation in Uganda; they particularly endorse the health systems strengthening aspect of the study. The APT-Sepsis collaboration is multi-disciplinary including health professionals, healthcare managers, policy experts and key stakeholders in community organisations.
Start Year 2021
 
Description Uganda Ministry of Health 26 January 2022 
Organisation Ministry of Health, Uganda
Country Uganda 
Sector Public 
PI Contribution The APT-Sepsis team met in person with MoH Richard Mugahi who will be the named contact with the Ministry of Health in Uganda and will provide support to project activities in Uganda.
Collaborator Contribution Representatives from the Ministry of Health and Apt-Sepsis researchers met to facilitate joint understanding of Apt-Sepsis aims and methods, and to endorse participation in the project. Those attending this informational and planning meeting included: MoH Richard Mugahi, Dr Catriona Waitt Pharmacologist University of Liverpool and IDI Uganda, Judith Nanyondo Project Manager IDI Uganda, Principal investigator Mohammed Lamorde Director IDI Uganda.
Impact This meeting was an initial information and planning meeting to enlist local government support in Uganda. The Ministry of Health endorsed the project and helped identify potential participating study sites. The Ministry of Health agreed that the project met many of the goals they had already identified for ongoing quality improvement work, including reduction of maternal sepsis. The MOH are pleased to offer support to the project which is ideal for implementation in Uganda a priority area they particularly endorse the health systems strengthening aspect of the study. The APT-Sepsis collaboration is multi-disciplinary including health professionals, healthcare managers, policy experts and key stakeholders in community organisations.
Start Year 2021
 
Title APT pocket references 
Description Pocket reference for staff with warning signs and potential treatment options for staff to improve management of sepsis cases. 
Type Preventative Intervention - Behavioural risk modification
Year Development Stage Completed 2024
Development Status Under active development/distribution
Impact Still in distribution 
 
Title Gestational wheels 
Description Gestational wheels for public use, which also contain information on recognising maternal sepsis 
Type Preventative Intervention - Behavioural risk modification
Year Development Stage Completed 2024
Development Status Under active development/distribution
Impact Unaware so far. Recently distributed 
 
Title Maternal sepsis posters 
Description Posters with information on maternal sepsis 
Type Preventative Intervention - Behavioural risk modification
Year Development Stage Completed 2023
Development Status Under active development/distribution
Impact Dissemination of information on recognising signs of maternal sepsis 
 
Title APT Sepsis dashboard 
Description Dashboard displaying maternal sepsis data accessible to staff 
Type Of Technology Webtool/Application 
Year Produced 2023 
Impact N/A 
 
Description 16.10.21 Maternal and Fetal Health Group Times Radio Programme 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The Maternal and Fetal Health Group were invited to Times Radio Company, one of the biggest radio companies in Malawi, in the month of October 2021 to present and discuss on maternal and newborn health issues as experienced by the group. The radio programmes took place every Saturdays from 5:00pm-6:00pm. The programmes were held live with call in audience who asked questions pertaining each topic presented and discussed. The topics presented were as follows: 1. Antenatal care and Infection prevention, 2. Postnatal care and male involvement, 3. Maternal Surveillance Platform, 4. Maternal health and adolescent mothers and 5. Maternal and Newborn health.
3 of 5 - Maternal Surveillance Platform

The discussion took a form where the radio presenter interviewed the maternal health group team and ministry of health on the maternal surveillance platform currently collecting direct and indirect effects of covid 19 on maternal cases including quality of care services. The interviewer asked on how the maternal surveillance platform works, flow of information, training over the system, barriers on facility systems and how the maternal surveillance platform addresses them. The audience was pleased to have a system collecting maternal health data that is reliable and specific.
The radio programme activities went on very well with a large audience involvement as witnessed through a lot of phone calls, questions and examples. The maternal health group conducted 5 sessions in total with all relevant information shared as was per designed script.
Year(s) Of Engagement Activity 2021
 
Description 2.10.21 Maternal and Fetal Health Group Times Radio Programme 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The Maternal and Fetal Health Group were invited to Times Radio Company, one of the biggest radio companies in Malawi, in the month of October 2021 to present and discuss on maternal and newborn health issues as experienced by the group. The radio programmes took place every Saturdays from 5:00pm-6:00pm. The programmes were held live with call in audience who asked questions pertaining each topic presented and discussed. The topics presented were as follows: 1. Antenatal care and Infection prevention, 2. Postnatal care and male involvement, 3. Maternal Surveillance Platform, 4. Maternal health and adolescent mothers and 5. Maternal and Newborn health.
Week 1 - Antenatal Care and Infection Prevention

A thorough description of antenatal care and Infection Prevention was done. Areas discussed included the nutritional interventions such as dietary interventions, iron and folic supplements, calcium supplements, vitamin A supplements. A discussion round maternal fetal assessment was carried out specifically in areas such as maternal assessment: Anemia, asymptomatic bacteriuria, gestational diabetes mellitus, tobacco use, substance abuse, HIV/AIDS and syphilis. Regarding fetal assessment: monitoring of fetal movements, symphysis-fundal height measurement for assessment of fetal growth and ultrasound scanning before 24 weeks for pregnant women to determine gestational age, detect fetal anomalies, multiple pregnancies were discussed. An extension of topics on preventive measures, interventions for physiologic symptoms and health systems to improve the utilization and quality of antenatal care were also presented and discussed with the audience.
The radio programme activities went on very well with a large audience involvement as witnessed through a lot of phone calls, questions and examples. The maternal health group conducted 5 sessions in total with all relevant information shared as was per designed script.
Year(s) Of Engagement Activity 2021
 
Description 23.10.21 Maternal and Fetal Health Group Times Radio Programme 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Week 4 of 5 - Maternal Health and adolescent mothers

The topic was in relation to adolescent mothers and how they can manage pregnancy, be supported in society and avoid discrimination in order to have a safe pregnancy, delivery and health baby. The topic emphasised the importance of adolescent pregnancies being treated equal as all other pregnancies. Health care services should be provided equally, and the society should take full responsibility of the pregnancies and help guide adolescents in accessing maternal health care service. The services discussed were antenatal care, labour and delivery and postnatal care. However, elements of community involvement were also discussed and how to support the adolescents during pregnancy, delivery and postnatal care.

The radio programme activities went on very well with a large audience involvement as witnessed through a lot of phone calls, questions and examples. The maternal health group conducted 5 sessions in total with all relevant information shared as was per designed script.
Year(s) Of Engagement Activity 2021
 
Description 30.10.21 Maternal and Fetal Health Group Times Radio Programme 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact The Maternal and Fetal Health Group were invited to Times Radio Company, one of the biggest radio companies in Malawi, in the month of October 2021 to present and discuss on maternal and newborn health issues as experienced by the group. The radio programmes took place every Saturdays from 5:00pm-6:00pm. The programmes were held live with call in audience who asked questions pertaining each topic presented and discussed. The topics presented were as follows: 1. Antenatal care and Infection prevention, 2. Postnatal care and male involvement, 3. Maternal Surveillance Platform, 4. Maternal health and adolescent mothers and 5. Maternal and Newborn health.

Week 5 of 5 - Maternal and Newborn Health

The discussion centred on maternal and newborn health in general. The discussion focused on services provided in maternity care and newborn care and how mothers and newborns are handled in different stages of maternal and newborn care. An overview of the maternal health care system was highlighted from community to national level and the importance of following the highlighted system for safe delivery and good outcomes was elaborated.

The radio programme activities went on very well with a large audience involvement as witnessed through a lot of phone calls, questions and examples. The maternal health group conducted 5 sessions in total with all relevant information shared as was per designed script.
Year(s) Of Engagement Activity 2021
 
Description 9.10.21 Maternal and Fetal Health Group Times Radio Programme 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Week 2 of 5 - Postnatal Care and Male involvement

A thorough description of postnatal care and its relevance was presented to the audience. This included statistics on postnatal visits in Malawi according to the Ministry of Health. The discussion focused on procedures at point of visit such as new-born assessment and maternal assessments in details. Dr. Mipando discussed results on the study conducted in Thyolo on Factors that influence attendance to Postnatal Care Services in Thyolo themed based on individual, community, and health systems level barriers. The study also discussed the strategies to optimize PNC uptake at health systems and community level.
A topic on male involvement was presented to the audience where a description of active and negative involvement was discussed thoroughly. The discussion centred on the relevance of male involvement in maternal health and how to involve them for successful maternal health care.

The radio programme activities went on very well with a large audience involvement as witnessed through a lot of phone calls, questions and examples. The maternal health group conducted 5 sessions in total with all relevant information shared as was per designed script.
Year(s) Of Engagement Activity 2021
 
Description APT Sepsis study and Anti Microbial Resistance coordination committee interface meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Discussing APT Sepsis study with regards to antibiotic use and ways to link between the two groups
Year(s) Of Engagement Activity 2022
 
Description APT Sepsis study materials review 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Review of study materials to ensure the content is in line with different guidelines for the country and ably meeting the goals of the intervention. Outcomes; All materials were reviwed and feedback on the same was given, changes were effected.
Year(s) Of Engagement Activity 2022
 
Description Association of Obstetricians and gynaecologist general meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Sensitising the obstetricians and gynaecologists
Year(s) Of Engagement Activity 2022
 
Description District Health Management Teams orientation to the APT Sepsis study 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Entry meetings for the study into the districts where study facilities will be. Outcomes: Site readiness assessment activities were easily done as the management were already aware of the study
Year(s) Of Engagement Activity 2022
 
Description District research committees representatives orientation to APT Sepsis study 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To ensure information about the study has reaced out to the steering committee for research in all districts as a recommendation by the Ministry of Health. To be aware of any research activities that are conducted in the facilities prior to APT initiation. Outcomes; Easy entries in the facilities during study initiation
Year(s) Of Engagement Activity 2022
 
Description ISUOG and FMF presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Ultrasound essentials-joint meeting with ISUOG and FMF (2023).
Year(s) Of Engagement Activity 2022
 
Description Kamuzu University of Health Sciences Conference (oral and poster). 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Kamuzu University of Health Sciences Conference (oral and poster).
Year(s) Of Engagement Activity 2022
 
Description Looking for additional cyclone Freddy camps 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A study update meeting that involved finding further cyclone Freddy camps to visit to assist in providing relief items.
Year(s) Of Engagement Activity 2023
 
Description Meeting with the Ministry of health officials 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Updating the Ministry on the APT Sepsis study and strategizing how to work with the ministry at all levels
Year(s) Of Engagement Activity 2022
 
Description Meetings with UCL 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Meetings with UCL to discuss process evaluation
Year(s) Of Engagement Activity 2023,2024
 
Description Ministry of health Quality management technical working group meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presenting the APT Sepsis study to stakeholders under the quality management in Malawi to learn what other partners are doing in relation to the study
Year(s) Of Engagement Activity 2022
 
Description PPI group meeting - 17 March 2022 Document review 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact 17 March 2022 Document review: Trained Immunity in BCG Vaccinated African Infants (TIA) study. Advising on the content of father's letter informing them about the study
Year(s) Of Engagement Activity 2022
 
Description PPI group meeting - Inception of the group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Orientation to PPI and to Research and research concepts
Year(s) Of Engagement Activity 2021
 
Description PPI group meeting - Study progress updates 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Study progress updates: APT, LACTATE and DIPLOMATIC (WKP 1-2-3-4) Studies
Year(s) Of Engagement Activity 2022
 
Description PPI poster presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact PPI Poster presentation
A combined health care provider and
lay patient and public involvement and
engagement in APT Sepsis and LACTATE
Studies. A case for Malawi
Year(s) Of Engagement Activity 2023
 
Description Quarterly newsletter 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Quarterly Newsletters - 4 issues, 1 each for UG & MW - 8 in total.
Year(s) Of Engagement Activity 2023
 
Description University of Birmingham meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Meetings with Birmingham to discuss cost effectiveness & sustainability of the programme
Year(s) Of Engagement Activity 2023,2024
 
Description Zonal Meeting - Malawi CENTRAL EASTERN 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Representatives from the Ministry of Health of Malawi, APT-Sepsis researchers and key stakeholders from the attending district met for an informational and planning meeting. Stakeholders helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones.
Year(s) Of Engagement Activity 2022
 
Description Zonal Meeting - Malawi CENTRAL WESTERN 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Representatives from the Ministry of Health of Malawi, APT-Sepsis researchers and key stakeholders from the attending district met for an informational and planning meeting. Stakeholders helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones.
Year(s) Of Engagement Activity 2022
 
Description Zonal Meeting - Malawi NORTH 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Representatives from the Ministry of Health of Malawi, APT-Sepsis researchers and key stakeholders from the attending district met for an informational and planning meeting. Stakeholders helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones.
Year(s) Of Engagement Activity 2022
 
Description Zonal Meeting - Malawi SOUTH EASTERN 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Representatives from the Ministry of Health of Malawi, APT-Sepsis researchers and key stakeholders from the attending district met for an informational and planning meeting. Stakeholders helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones.
Year(s) Of Engagement Activity 2022
 
Description Zonal Meeting - Malawi SOUTH WESTERN 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Representatives from the Ministry of Health of Malawi, APT-Sepsis researchers and key stakeholders from the attending district met for an informational and planning meeting. Stakeholders helped identify potential hospitals and completed a feasibility form which will help identify site suitability for the study. All teams were enthusiastic about the study and keen to be involved and provide feedback to help the team implement the project across the zones.
Year(s) Of Engagement Activity 2022