Detection and management of postpartum haemorrhage: Qualitative evidence on healthcare providers' knowledge and practices in Kenya, Nigeria, and South Africa.
Detection and management of postpartum haemorrhage: Qualitative evidence on healthcare providers' knowledge and practices in Kenya, Nigeria, and South Africa.
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DOI：
10.3389/fgwh.2022.1020163
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发表时间：
2022
影响因子：
--
通讯作者：
Bohren, Meghan A.
中科院分区：
文献类型：
--
作者：
Akter, Shahinoor;Forbes, Gillian;Miller, Suellen;Galadanci, Hadiza;Qureshi, Zahida;Fawcus, Sue;Hofmeyr, G. Justus;Moran, Neil;Singata-Madliki, Mandisa;Amole, Taiwo Gboluwaga;Gwako, George;Osoti, Alfred;Thomas, Eleanor;Gallos, Ioannis;Mammoliti, Kristie-Marie;Coomarasamy, Arri;Althabe, Fernando;Lorencatto, Fabiana;Bohren, Meghan A.
关键词：
产后出血是全球孕产妇死亡的主要原因。大多数PPH死亡可以通过及时发现和管理来避免;然而，关键挑战仍然存在。一项多国随机分组试验（E-MOTIVE）将在医院环境中引入早期发现和第一反应PPH管理的临床护理包。这项形成性定性研究旨在探讨医疗保健提供者对阴道分娩后PPH检测和管理的知识和实践，为E-MOTIVE的设计和实施提供信息。在2020年7月至2021年6月期间，对肯尼亚，尼日利亚和南非9家医院的45名孕产妇保健提供者（助产士，护士，医生，管理人员）进行了半结构化定性访谈。采用了专题分析方法。确定了四个关键主题，这些主题在不同的背景下有所不同：紧急产科护理的在职培训;对PPH的知识有限; PPH检测的当前方法;以及当前PPH管理和相关挑战。PPH被认为是一种紧急情况，但对PPH的理解不同。早期PPH检测受限于失血量视觉估计的主观性质。缺乏PPH检测和使用视觉估计的专业知识可能会导致PPH管理的延迟。训练有素的工作人员和必要资源的短缺以及医院间转诊延迟是PPH管理的常见障碍。迫切需要解决特定背景下的障碍，在医院环境中早期和及时发现和管理PPH。这些发现将用于制定循证实施策略，例如改进在职培训和客观测量失血量，这是E-MOTIVE试验的关键组成部分（试验注册：ClinicalTrials.gov：NCT 04341662）。
Postpartum haemorrhage (PPH) is the leading cause of maternal death globally. Most PPH deaths can be avoided with timely detection and management; however, critical challenges persist. A multi-country cluster-randomised trial (E-MOTIVE) will introduce a clinical care bundle for early detection and first-response PPH management in hospital settings. This formative qualitative study aimed to explore healthcare providers' knowledge and practices of PPH detection and management after vaginal birth, to inform design and implementation of E-MOTIVE. Between July 2020–June 2021, semi-structured qualitative interviews were conducted with 45 maternity healthcare providers (midwives, nurses, doctors, managers) of nine hospitals in Kenya, Nigeria, and South Africa. A thematic analysis approach was used. Four key themes were identified, which varied across contexts: in-service training on emergency obstetric care; limited knowledge about PPH; current approaches to PPH detection; and current PPH management and associated challenges. PPH was recognised as an emergency but understanding of PPH varied. Early PPH detection was limited by the subjective nature of visual estimation of blood loss. Lack of expertise on PPH detection and using visual estimation can result in delays in initiation of PPH management. Shortages of trained staff and essential resources, and late inter-hospital referrals were common barriers to PPH management. There are critical needs to address context-specific barriers to early and timely detection and management of PPH in hospital settings. These findings will be used to develop evidence-informed implementation strategies, such as improved in-service training, and objective measurement of blood loss, which are key components of the E-MOTIVE trial (Trial registration: ClinicalTrials.gov: NCT04341662).
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影响因子：
3.4
作者：
Bohren MA;Lorencatto F;Coomarasamy A;Althabe F;Devall AJ;Evans C;Oladapo OT;Lissauer D;Akter S;Forbes G;Thomas E;Galadanci H;Qureshi Z;Fawcus S;Hofmeyr GJ;Al-Beity FA;Kasturiratne A;Kumarendran B;Mammoliti KM;Vogel JP;Gallos I;Miller S
通讯作者：
Miller S
DOI：
10.1186/s13690-021-00711-3
发表时间：
2021-12-03
期刊：
Archives of public health = Archives belges de sante publique
影响因子：
--
作者：
Fite MB;Assefa N;Mengiste B
通讯作者：
Mengiste B
影响因子：
3.1
作者：
Beltman JJ;van den Akker T;Bwirire D;Korevaar A;Chidakwani R;van Lonkhuijzen L;van Roosmalen J
通讯作者：
van Roosmalen J
DOI：
10.1016/j.ijgo.2015.06.047
发表时间：
2016-01-01
影响因子：
3.8
作者：
Braddick, Louise;Tuckey, Victoria;Stokes, Tim
通讯作者：
Stokes, Tim
影响因子：
3.1
作者：
Flanagan SV;Razafinamanana T;Warren C;Smith J
通讯作者：
Smith J