Factors influencing implementation of postpartum haemorrhage management guidelines among health care providers in Kilimanjaro region

Abstract

Background: One of the most common life-threatening complications of labor is postpartum haemorrhage (PPH). It usually happens without warning or warning signs or symptoms, and it often happens without any predisposing factors. The most common causes of PPH are uterine atony (which occurs in about 80% of cases), retained placenta, and genital tract trauma. Primary interventions such as active management of the third stage of labor, uterotonic and uterine massage, all of which are well described in the guidelines for preventing and managing postpartum haemorrhage, are all effective in preventing and managing PPH. Objective: The study aimed to determine factors influencing the implementation of postpartum haemorrhage management guidelines among health care providers in Kilimanjaro Region. Methodology: A descriptive cross-sectional study was conducted using a quantitative data collection approach. Data was collected using self-administered structured questionnaires. The study included all enrolled and registered nurses, midwives, and physicians working in maternity units at selected facilities. Multistage cluster sampling was used because it allowed the researcher to collect data in smaller, more productive groups while saving money and time. The project will involve six (6) health centers and two (2) hospitals.All participants signed a written consent form. Descriptive statistics and logistic regression analysis were used to analyze the data. Results: The implementation of the PPH management guideline is influenced by participants over the age of 25, with a higher education and more than 5 years of college or university work experience, as well as nurses/midwives and physicians with more than 5 years of work experience. Health care providers can also improve their skills in implementing the PPH management guideline by participating in on-the-job training or refresher courses. Two health system factors that influenced the implementation of the PPH management guideline were the recruitment and allocation of competent health care providers in the maternity unit. Furthermore, health-care facilities must have sufficient and easily accessible equipment and supplies. Conclusion: The implementation of PPH management guidelines is influenced by qualified personnel with good communication skills and more than 5 years of experience working in a maternity unit. Recommendations: The government or health institutions should hire more qualified personnel who will adhere to all postpartum haemorrhage prevention and management principles. The government and health institutions should provide frequent training and refresher courses, as well as supportive supervision, to keep health care providers' skills up to date. The government must ensure that adequate equipment and suppliers, as well as reliable transportation (ambulance) within health-care facilities, are always available.