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Research at SAFER

Creating safer healthcare practices requires a multi-faceted approach involving three main factors; medical science, educational efficiency and local implementation (The Utstein Formula for Survival, Photo 1). Improvement in medical science will turn into better patient treatment guidelines. Educational efficiency can be defined as knowledge and skills translation to patient caregivers. Local implementation is the ultimate goal: actual delivery of optimal health care to each patient.

Photo 1; the Utstein Formula for Survival

Photo 1; the Utstein Formula for Survival

It is predicted that all factors in the formula contribute equally to patient outcome. Hypothetically, if all the factors are optimal (1 x 1 x 1 = 1), patient survival would be 100%. In the real world, gaps exist in medical guidelines, but even more, educational efficiency limits diffusion of best practices and local implementation constrains uptake. Improvement in one or all three multiplicands will improve patient outcome. The “formula for survival” provides a conceptual framework and can be used as a template to investigate and improve health care systems related to many different patient groups and to better understand the variability in patient outcome.

Research at SAFER for «SAFER Practices» is founded on the “Formula for Survival” and therefore welcomes a great variety of different research areas, methods and professionals. Our focus includes both national and international projects, with a particular interest in interdisciplinary collaboration and competencies.

The Safer Births Project

“Safer Births” is a research and development project to improve fetal heart rate monitoring, newborn resuscitation and perinatal outcomes, worldwide (

Globally, around 45% of under 5-year mortality occur in the neonatal period, often as a consequence of labor complication and birth asphyxia. Most of these deaths are preventable with appropriate, low-cost, easy-to-use tools and technologies coupled with focused and simple training programs and implementation strategies.

“Safer Births” is a collaboration between 4 clinical research sites in Tanzanian, Norwegian (SAFER, University of Stavanger, Stavanger University Hospital, University of Oslo, University of Bergen, The Arctic University of Norway, Norwegian Institute of Public Health) and International Research Institutions (Muhimbili University of Health and Allied Sciences, Weill Cornell Medical College, Trinity College) and Laerdal Global Health. The project seeks to develop new innovative products and training methods and to establish new knowledge through research. Several sub-studies are ongoing and to be initiated in near future. Different research methods (e.g. randomized controlled studies, observational descriptive studies, and qualitative studies) are utilized to answer specific research questions or hypothesis.

The final goals are improved international treatment guidelines, more competent and better equipped birth attendants, and increased newborn survival.

Hege Ersdal is the External Principal Investigator of Safer Births. The project has an overall budget of approximately 75 million NOK and includes around 80 researchers/research staff. The project is funded by Globvac – the Norwegian Research Council, The Laerdal Foundation for Acute Medicine and Saving Life at Birth Grand Challenge. Currently, 10 PhD candidates are engaged in the project; Jørgen Linde, Estomih Mduma, Paschal Mdoe, Robert Moshiro, Monica Thallinger, Huyen Vu, Kari Holte, Sara Lafontan, and Benjamin Kamal. One PhD candidate successfully defended her thesis in 2014; Ellen Nelissen, and three Masters have been finalized; Ingvild Tjelmeland (2012), Kristiane Aasen Engebretsen (2011), Mari Eide Andersen (2011) affiliated to the project.

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