scholarly journals Obstetric care providers’ knowledge, practice and associated factors towards active management of third stage of labor in Sidama Zone, South Ethiopia

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Zelalem Tenaw ◽  
Zemenu Yohannes ◽  
Abdela Amano
2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Wondwosen Molla ◽  
Asresash Demissie ◽  
Marta Tessema

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.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Getu Engida Wake ◽  
Girma Wogie

Introduction. Globally, postpartum hemorrhage is the most common cause of maternal mortality and morbidity, and it accounts for more than 25% of all maternal deaths. The majority of death due to postpartum hemorrhage is caused by uterine atony. Routine and correct usage of active management of the third stage of labor decreases the occurrence of postpartum hemorrhage by 60% when compared to expectant management of the third stage of labor. The purpose of this study was to assess midwife knowledge, practice, and associated factors towards active management of the third stage of labor at governmental health institutions in the Tigray region, 2018. Results. These study results showed that from the total study participants ( N = 278 ), 170 (61.2%) were good in knowledge and 121 (43.5%) were good in practice towards active management of the third stage of labor. Training related to active management of the third stage of labor ( AOR = 2.119 , 95 % CI = 1.141 , 3.3937) and practice level of midwives ( AOR = 8.089 , 95 % CI = 4.103 , 15.950) became significantly associated with the knowledge level. The educational level of midwives ( AOR = 3.811 , 95 % CI = 2.015 , 7.210), training related to active management of the third stage of labor ( AOR = 2.591 , 95 % CI = 1.424 , 4.714), and knowledge level of midwives towards active management of the third stage of labor ( AOR = 7.324 , 95 % CI = 3.739 , 14.393) were significantly associated with the practice level. This study showed that training related to active management of the third stage of labor was significantly associated with the knowledge and practice level of midwives. The educational level and knowledge level of midwives were significantly associated with the practice level of midwives towards active management of the third stage of labor. Therefore, midwives should update their academic level and knowledge. Health institutions in collaboration with the Tigray Regional Health Bureau should arrange training for all midwives to bring change.


2020 ◽  
Author(s):  
Asteray Ayenew ◽  
Biruk Ferede Zewdu

Abstract Background Globally, a total of 13.6 million women have died due to maternal causes from 1990 to 2015. Majority of these deaths occurred in resource-limited countries. Among the causes of these deaths, obstructed and prolonged labor covers the highest percentage, which could be prevented by cost-effective and affordable health interventions like partograph use. Therefore, this systematic review and meta-analysis aimed to assess the level of partograph utilization among obstetric care providers and its associated factors in Ethiopia. Method for this review, we used the standard PRISMA checklist guideline. Different online databases were used for the review: PubMed/Medline, Google Scholar, EMBASE, Cochrane Library, HINARI, WHO Afro Library Databases, and African Online Journals. Based on the adapted PICO principles, different search terms were applied to achieve and access all the essential articles. Microsoft Excel was used for data entrance and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) for data analysis.Result Nineteen studies were included in this systematic review and meta-analysis with a total of 6237 obstetric care providers. The overall pooled prevalence of partograph utilization was 59.95% (95%CI: 46.8–73.09, I2 =99.4%, P <0.001). Being midwifery profession (adjusted odds ratio (AOR):3.97; 95% confidence interval (CI):95%CI:2.63–5.99, I2 =28.8%, P=0.198), presence of supervision (AOR = 3.21; 95%CI: 2.22–4.66, I2=0.0%, p=0.742), Basic Emergency Obstetric and Newborn Care (BEmONC) training (AOR  = 2.90; 95% CI: 2.19–3.84, I2=36.9%, P=0.13), Knowledge of partograph (AOR=2.5; 95%CI: 1.6–3.8, I2=64.58%, P=0.024), on-the-job refresher training on partograph (AOR =5.7; 95%CI:2.5–12.9, I2=87.8%, P<0.001), favorable attitude (AOR=2.12; 95%CI: 1.48–3.04, I2=0.0%, P=0.58), and working at health center (AOR=3.50; 95%CI: 2.49–4.92, I2=49.1%, P=0.08) were the determinant factors for partograph use among obstetric acre providers in Ethiopia.Conclusion The overall pooled prevalence of partograph utilization among obstetric care providers was low. Therefore, supportive supervision, providing Basic Emergency Obstetric and Newborn Care training, on-the-job refresher training on partograph, and promoting midwifery profession are strongly recommended to increase the use of partograph.


2019 ◽  
Author(s):  
biresaw wassihun alemu ◽  
Agegnehu Bante ◽  
Direslign Miskir ◽  
Teklemariam Gultie ◽  
Kassahun Gebayehu

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.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yosef Haile ◽  
Fikru Tafese ◽  
Tesfaye Dagne Weldemarium ◽  
Mulugeta Hailu Rad

Background. A partograph is a graphic representation of labor which is used by health professionals for monitoring labor progress and fetal and maternal wellbeing. However, its utilization and associated factors have not been studied yet in Hadiya Zone, Southern Ethiopia. Hence, the aim of this study was to determine partograph utilization and associated factors among obstetric care providers at public health facilities in Hadiya Zone, Southern Ethiopia. Methods. A facility-based cross-sectional study was conducted on 436 health professionals. The study was conducted from March 04 to April 07, 2019. A simple random sampling method was carried out to select 19 health facilities and study participants from selected facilities. Data was collected using a pretested structured questionnaire, entered into EPI-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics and binary and multivariable logistic regression analyses were done. P values less than 0.05 were used to declare significant association between dependent and independent variables. Results. The overall magnitude of partograph utilization was found to be 54.4%, and finding from data abstraction from a document revealed that out of 18 parameters, only 10 parameters were recorded completely. Type of health facility (hospital as compared to HC) (AOR=2.96; CI=1.71, 5.12), received on-the-job training on partograph (AOR=7.06; CI=4.3, 11.37), knowledgeable about partograph (AOR=2.12; CI=1.3, 3.9), and favorable attitude toward partograph use (AOR=1.8; CI=1.12−2.97) were significantly associated with partograph use. Conclusion. Overall partograph utilization was low, and incomplete recording of required parameters on partograph was observed in this study. Participants who received on-the-job training on partograph, who are working in a hospital, who are knowledgeable about partograph, and who have favorable attitude toward partograph use were factors affecting partograph use positively.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Biruk Ferede Zewdu

Abstract Background Globally, a total of 13.6 million women have died due to maternal causes from 1990 to 2015. Majority of these deaths occurred in resource-limited countries. Among the causes of these deaths, obstructed and prolonged labor covers the highest percentage, which could be prevented by cost-effective and affordable health interventions like partograph use. Therefore, this systematic review and meta-analysis aimed to assess the level of partograph utilization among obstetric care providers and its associated factors in Ethiopia. Method For this review, we used the standard PRISMA checklist guideline. Different online databases were used for the review: PubMed/Medline, Google Scholar, EMBASE, Cochrane Library, HINARI, WHO Afro Library Databases, and African Online Journals. Based on the adapted PICO principles, different search terms were applied to achieve and access all the essential articles. Microsoft Excel was used for data entry and Stata version 11.0 (Stata Corporation, College Station, TX, USA) for data analysis. Result Nineteen studies were included in this systematic review and meta-analysis with a total of 6237 obstetric care providers. The overall pooled prevalence of partograph utilization was 59.95% (95% CI 46.8–73.09, I2 = 99.4%, P < 0.001). Being in midwifery profession (adjusted odds ratio (AOR) 3.97; 95% confidence interval (CI) 2.63–5.99, I2 = 28.8%, P = 0.198), presence of supervision (AOR = 3.21; 95% CI 2.22–4.66, I2 = 0.0%, P = 0.742), Basic Emergency Obstetric and Newborn Care (BEmONC) training (AOR = 2.90; 95% CI 2.19–3.84, I2 = 36.9%, P = 0.13), knowledge of partograph (AOR = 2.5; 95% CI 1.6–3.8, I2 = 64.58%, P = 0.024), on-the-job refresher training on partograph (AOR = 5.7; 95% CI 2.5–12.9, I2 = 87.8%, P < 0.001), favorable attitude (AOR = 2.12; 95% CI 1.48–3.04, I2 = 0.0%, P = 0.58), and working at health center (AOR = 3.50; 95% CI 2.49–4.92, I2 = 49.1%, P = 0.08) were the determinant factors for partograph use among obstetric care providers in Ethiopia. Conclusion The overall pooled prevalence of partograph utilization among obstetric care providers was low. Therefore, supportive supervision, providing Basic Emergency Obstetric and Newborn Care training, on-the-job refresher training on partograph, and promoting midwifery profession are strongly recommended to increase the use of partograph.


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