International Guidelines for the Advanced Life Support in Obstetrics (ALSO®) and
Basic Life Support in Obstetrics (BLSO®) Programs
The following guidelines were designed to facilitate the application and review process for introducing the ALSO/BLSO Programs in a country via an established organization or other entity.
All interested entities are required to submit a written application or proposal to the American Academy of Family Physicians (AAFP) Maternity Care and Patient Safety Advisory Board for approval. The proposal(s) are to include the following information.
1. Date of request
2. Name of the individual completing the application (please include title and relation to the organization / entity).
3. Please briefly describe the reason for implementing the ALSO and/or BLSO Programs.
4. Please provide your objectives for the program(s).
5. Please provide projected training and implementation plans.
6. Include a statement of any desire to translate the ALSO/BLSO materials. All requests to translate materials must follow the Guidelines for Obtaining Permission to Publish International Translations of the ALSO/BLSO Materials.
7. Please provide how you will fund the implementation of the program(s) and future courses.
8. Please provide who practices maternity care in your country (obstetricians, midwives, general practitioners, nurses or traditional birth attendants).
9. Please provide information on the institution or organization that will oversee the program and ensure its sustainability.
Please address the following:
A. Course logistics
1) How will course materials be funded (duplication, paper etc.)
2) Are there plans for food and beverages during breaks and lunch?
3) Which languages are spoken by the course participants?
4) Will interpreters be available if needed?
5) How will the course be advertised if applicable?
6) Will there be media access at the time of the course(s)?
7) It is mandatory that all faculty be able to attend a pre-course training meeting.
8) If an ALSO Instructor Course will be taught, please answer the same questions for the Instructor Course.
B. Host country epidemiology
1) Where are births occurring (hospitals, homes, birth centers), and what is the level of care at each site (traditional birth attendant, skilled birth attendant, nurse midwife, physician).
2) What proportion of hospitals can perform a cesarean delivery?
3) What are the leading causes of maternal and infant mortality?
4) How common are perinatal conditions such as pre-eclampsia, preterm delivery, Group B strep infection, HIV and other STD’s?
5) What is the average number of deliveries performed by the prospective participants per year?
6) Results of the pre-course needs assessment - what are the needs of the learners, what settings do they work in, how do you perceive that ALSO/BLSO would assist them in caring out their duties, how will the learners be able to incorporate their new knowledge into their work, who will support them?
C. Host country medical practice
1) Nationally, who practices maternity care and what are the various levels of training?
2) What are the rural and urban cesarean delivery rates?
3) What are local practices regarding breech delivery?
4) Are neonatal resuscitation programs (NRP) available?
1) What are culturally-specific attitudes and practices relevant to the birthing process?
E. Technology and resources
1) Is there funding to purchase mannequins/soft pelvises for training?
2) What is the availability of medicines including magnesium sulfate, terbutaline, carboprost, misoprostol and methergine?
3) What is the availability of electricity and/or refrigeration?
4) What is the availability of oxygen?
5) What is the cost and availability of laboratory testing? The recommendations for universal testing for Group B Streptococcus and HIV testing may be reconsidered. Recommendations for Kleihauer-Betke testing may not be realistic.
6) What audiovisual aids and other equipment are available for use?
AAFP staff, in consultation with the representation of the ALSO® Advisory Board, will negotiate any business arrangements based on the needs of the international sponsoring entity. A royalty fee will be determined by the AAFP for each proposal.
Please forward the requested information to:
David Gregory MD, Chair ALSO® Advisory Board
c/o Diana Winslow, R.N., B.S.N.
American Academy of Family Physicians
Maternity Care and Patient Safety Department
11400 Tomahawk Creek Parkway
Leawood, Kansas 66206
913-906-6000 ext 6550