scholarly journals Active Management of Third Stage of Labor: Practice and Associated Factors among Obstetric Care Providers in North Wollo, Amhara Region, Ethiopia

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wondwosen Molla ◽  
Asresash Demissie ◽  
Marta Tessema
Keyword(s):  
Confidence Interval ◽  
Work Experience ◽  
Good Practice ◽  
Obstetric Care ◽  
Active Management ◽  
Drug Preparation ◽  
Care Providers ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Obstetric Care Providers

Background. World Health Organization strongly recommends that every obstetrical provider at birth needs to have knowledge and skills on active management of the third stage of labor and use it routinely for all women. However, implementation of this lifesaver intervention by skilled birth attendants is questionable because 3% to 16.5% of women still experience postpartum hemorrhage. Even though coverage of giving births at health facilities in Ethiopia increases, postpartum hemorrhage accounts for 12.2% of all maternal deaths occurring in the country. Lack of the necessary skills of birth attendants is a major contributor to these adverse birth outcomes. Objectives. This study aimed to assess the active management of the third stage of labor practice and associated factors among obstetric care providers. Methods. An institution-based cross-sectional study design was applied from March 15 to April 15, 2020. Multistage sampling techniques were used to get 254 participants, and data were collected using self-administered structured questionnaires and an observation checklist. Data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for analyses. The multivariable logistic regression model was used at 95% confidence interval with P value <0.05. Among the 232 providers participating in the study, only 75 (32.3%) of respondents had a good practice. The practice of the provider was significantly associated with work experience (adjusted odd ratio 0.206 (95% confidence interval, 0.06–0.63)), knowledge (adjusted odd ratio (2.98 (95% confidence interval, 1.45–6.14)), the presence of assistance (adjusted odd ratio 2.04 (95% confidence interval, 1.06–3.93)), and time of uterotonic drug preparation (adjusted odd ratio 4.69 (95% confidence interval, 2.31–9.53)). Conclusion. Only one-third of obstetric care providers had good practice during active management of third stage of labor. Practice was significantly associated with work experience, knowledge, the presence of assistance during third-stage management, and time of uterotonic drug preparation. Consistent and sustainable on job training and clinical audit should be applied in all facilities with regular supportive supervision and monitoring. Furthermore, team work and adequate preparation should be done to facilitate the management of active third stage of labor.

scholarly journals Active management of third stage of labor practice and associated factors among skilled birth attendants in Gamo and Gofa zone, Southern, Ethiopia

2019 ◽  
Author(s):  
biresaw wassihun alemu ◽  
Agegnehu Bante ◽  
Direslign Miskir ◽  
Teklemariam Gultie ◽  
Kassahun Gebayehu
Keyword(s):  
Public Health ◽  
Associated Factors ◽  
Good Practice ◽  
Delivery Room ◽  
Active Management ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Service Training

Abstract Background Active management of third stage of labour is evidence based inexpensive and effective intervention for the prevention of postpartum hemorrhage which is the leading cause of maternal mortality in low and middle income countries. In spite of this technique being espoused in Ethiopia and internationally, its actual practice and factors influencing its practice were yet to be established.Objective The aim of this study was to assess status of active management of third stage of labor practice and associated factors among skilled birth Attendants in public health facilities of Gamo and Gofa zone, southern EthiopiaMethods Facility based cross-sectional study design was employed on 356 skilled birth attendants working in public health facilities of Gamo and Gofa zone. Semi- structured questionnaire with observational checklist was used to collect the data. Data was checked and entered into Epi info version 7 then exported to statically package for social science version 24 for analysis. Univariate, Bivariate and multivariable analysis with 95% CI was carried out.Result The finding of the study revealed that 48.1% of the skilled care providers were good practice towards active management of third stage of labour with 95% CI (43-53). Skilled birth attendants having clinical experience of 7 years and above were 2.52 times more likely performed good practice than others [AOR=7.00(95%CI, 1.82,7.75)] and those skilled birth attendants taken in service training were 2.55 times more likely performed good practice than others [AOR=2.55(95%CI, 1.99,6.56)]. In addition to this those skilled birth attendants who were working in favorable delivery rooms were 1.86 times more likely performed good practice than others [AOR= 1.86(95%CI, 1.32-2.24)]Conclusion The finding of this study showed that the practice of active management of third stage of labour was poor. Clinical year of experience, having conducive delivery room and taking in –service training on active of third management of labour were some of the factors associated with good practice. So crating satisfactory delivery room and providing training on active of third management of labour is very important to enhance their knowledge and skill of birth attendant.

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