Factors that influence management of postpartum hemorrhage among midwives in a rural setting in Kenya

Muthoni, Doris Mumbi; Kabue, Priscilla; Ambani, Elizabeth Kurwa

doi:10.4314/ahs.v21i1.39

Cited by 5 publications

(7 citation statements)

References 12 publications

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“…Concerning examination of lochia for amount and consistency in the early postpartum period, the current study showed that examination was not done by more than one-third of the study nurses and that is similar to the findings of (Muthoni, Kabue & Ambani, 2021), who found that the most of study nurses did not examine lochia for amount and consistency in early postpartum period. The findings is not agree with the study of (Elfaki, 2015) which found that examination of lochia for amount and consistency in early postpartum period were done by the majority of the nurses from the researcher point of view may be related to increased number of cases according to number of nurses.…”

Section: Discussionsupporting

confidence: 84%

Assessment of nurses’ knowledge and skills toward postpartum hemorrhage prevention

Elbadrawy

EL-Moneim

Mohamady

2022

ijhs

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Background: Maternal death from postpartum hemorrhage is a key maternal health indicator and directly reflects the care provided during the intrapartum and postpartum periods. The aim is to assess nurses’ knowledge and skills toward postpartum hemorrhage prevention. Study design: A descriptive design was utilized to conduct the study. Study Setting: The study was conducted at the postpartum unit at the obstetrics and gynecology department at Mansoura university hospital. Sample: A convenienve sample of maternity nurses (70). Tools: Three tools were used for data collection: Tool I: A structured interviewing questionnaire. Tool II: knowledge assessment sheet toward postpartum hemorrhage prevention. Tool III: observational checklist to assess nurses’ skills toward postpartum hemorrhage prevention. Results: The present study reveals that more than half of the nurses’ total knowledge toward postpartum hemorrhage prevention was poor, while nearly two-third of the nurses’ total skills toward postpartum hemorrhage prevention were inadequate. The study indicated a statistically high significant relation between the total nurses’ knowledge and their total skills toward postpartum hemorrhage prevention. Conclusion: The present study concluded that the nurses had inadequate total skills score toward postpartum hemorrhage prevention. Recommendations: Development of educational programs to improve nurses’ knowledge and skills toward prevention of postpartum hemorrhage.

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Section: Discussionsupporting

confidence: 84%

Assessment of nurses’ knowledge and skills toward postpartum hemorrhage prevention

Elbadrawy

EL-Moneim

Mohamady

2022

ijhs

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“…The knowledge factor includes knowledge on the prevention of PPH, correct use of prophylactic uterotonics, uterine massage during the third stage of labour, examination of the placenta and management of PPH (Muthoni et al, 2021). Due to knowledge deficiencies, midwives often feel confused and frustrated with PPH management (Ramavhoya et al, 2021).…”

Section: Insufficient Knowledge and Skillsmentioning

confidence: 99%

“…Midwives' professional qualifications, clinical experience, knowledge level, age, working years and education level are closely related to the prevention and management of PPH (Muthoni et al, 2021;Ramadhani et al, 2020;Voillequin et al, 2022;Wake & Wogie, 2020).…”

Section: Insufficient Knowledge and Skillsmentioning

confidence: 99%

“…This situation further affects the success rate of treating PPH and poses challenges to the management of PPH. In addition, midwives' professional qualifications, clinical experience, knowledge level, age, working years and education level are closely related to the prevention and management of PPH (Muthoni et al., 2021 ; Ramadhani et al., 2020 ; Voillequin et al., 2022 ; Wake & Wogie, 2020 ). Although some studies have investigated the challenges related to PPH, there are no systematic reviews on this topic in particular.…”

Section: Introductionmentioning

confidence: 99%

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Roles and challenges encountered by midwives in the management of postpartum haemorrhage following normal vaginal delivery: A scoping review

Yao,

Shan,

et al. 2024

Nursing Open

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AimsTo establish a comprehensive understanding of the roles of midwives and the challenges they encounter in the prevention, diagnosis and management of postpartum haemorrhage (PPH) following normal vaginal delivery.DesignWe conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis for Scoping Reviews (PRISMA‐ScR) recommendations.MethodsWe considered studies related to the roles of midwives and the challenges they encounter in the prevention, diagnosis and management of PPH during vaginal delivery. We excluded guidelines, consensuses, abstracts of meetings and non‐English language studies. Databases, including the Cochrane Library, PubMed, Web of Science, Ovid, Medline, Embase, JBI EBP and BIOSIS Previews, were searched on January 1, 2023, with no time limitations.ResultsWe included 28 publications. Midwives play important roles in the prevention, diagnosis and management of postpartum haemorrhage during vaginal delivery. In the prevention of PPH, midwives' roles include identifying and managing high‐risk factors, managing labour and implementing skin‐to‐skin contact. In the diagnosis of PPH, midwives' roles include early recognition and blood loss estimation. In the management of PPH, midwives are involved in mobilizing other professional team members, emergency management, investigating causes, enhancing uterine contractions, the repair of perineal tears, arranging transfers and preparation for surgical intervention. However, midwives face substantial challenges, including insufficient knowledge and skills, poor teamwork skills, insufficient resources and the need to deal with their negative emotions. Midwives must improve their knowledge, skills and teamwork abilities. Health care system managers and the government should give full support to midwives. Future research should focus on developing clinical practice guidelines for midwives for preventing, diagnosing and managing postpartum haemorrhage.

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“…The existing literature on knowledge of PPH protocols in SSA has focused mainly on preventive care through active management of the third stage of labor (AMSTL), with little in-depth study of knowledge of PPH management. Additionally, past studies have generally used brief selfadministered provider questionnaires [8,9,[18][19][20]. More evidence is needed on gaps in health providers' knowledge of comprehensive clinical protocols for PPH risk assessment, prevention, and management.…”

Section: Introductionmentioning

confidence: 99%

Health care providers’ knowledge of clinical protocols for postpartum hemorrhage care in Kenya: a cross-sectional study

Henry

Clarke-Deelder

Han

et al. 2022

BMC Pregnancy Childbirth

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Background Postpartum hemorrhage (PPH) remains the leading cause of maternal death worldwide despite its often-preventable nature. Understanding health care providers’ knowledge of clinical protocols is imperative for improving quality of care and reducing mortality. This is especially pertinent in referral and teaching hospitals that train nursing and medical students and interns in addition to managing emergency and referral cases. Methods This study aimed to (1) measure health care providers’ knowledge of clinical protocols for risk assessment, prevention, and management of PPH in 3 referral hospitals in Kenya and (2) examine factors associated with providers’ knowledge. We developed a knowledge assessment tool based on past studies and clinical guidelines from the World Health Organization and the Kenyan Ministry of Health. We conducted in-person surveys with health care providers in three high-volume maternity facilities in Nairobi and western Kenya from October 2018-February 2019. We measured gaps in knowledge using a summative index and examined factors associated with knowledge (such as age, gender, qualification, experience, in-service training attendance, and a self-reported measure of peer-closeness) using linear regression. Results We interviewed 172 providers including consultants, medical officers, clinical officers, nurse-midwives, and students. Overall, knowledge was lowest for prevention-related protocols (an average of 0.71 out of 1.00; 95% CI 0.69–0.73) and highest for assessment-related protocols (0.81; 95% CI 0.79–0.83). Average knowledge scores did not differ significantly between qualified providers and students. Finally, we found that being a qualified nurse, having a specialization, being female, having a bachelor's degree and self-reported closer relationships with colleagues were statistically significantly associated with higher knowledge scores. Conclusion We found gaps in knowledge of PPH care clinical protocols in Kenya. There is a clear need for innovations in clinical training to ensure that providers in teaching referral hospitals are prepared to prevent, assess, and manage PPH. It is possible that training interventions focused on learning by doing and teamwork may be beneficial.

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Factors that influence management of postpartum hemorrhage among midwives in a rural setting in Kenya

Cited by 5 publications

References 12 publications

Assessment of nurses’ knowledge and skills toward postpartum hemorrhage prevention

Assessment of nurses’ knowledge and skills toward postpartum hemorrhage prevention

Roles and challenges encountered by midwives in the management of postpartum haemorrhage following normal vaginal delivery: A scoping review

Health care providers’ knowledge of clinical protocols for postpartum hemorrhage care in Kenya: a cross-sectional study

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