ArticleBulletin of the World Health Organization2015
Facility-based active management of the third stage of labour: assessment of quality in six countries in sub-Saharan Africa.
Article in Bulletin of the World Health Organization, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Midwives' experiences with implementation of active management of third stage of labor in Sub-Saharan Africa: a systematic review.BMC pregnancy and childbirth · 2025Pooled it
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- Quality of care for postpartum hemorrhage: A direct observation study in referral hospitals in Kenya.PLOS global public health · 2023Article
- Primary postpartum hemorrhage and associated factors among delivering women in Gedeo Zone, Southern Ethiopia.Frontiers in medicine · 2023Article
- Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study.Reproductive health · 2021Article
- Facility-level determinants of quality routine intrapartum care in Afghanistan.BMC pregnancy and childbirth · 2021Article
- Barriers inhibiting effective detection and management of postpartum hemorrhage during facility-based births in Madagascar: findings from a qualitative study using a behavioral science lens.BMC pregnancy and childbirth · 2021Article
- Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences.BMC pregnancy and childbirth · 2021Observational
- Influencing factors for prevention of postpartum hemorrhage and early detection of childbearing women at risk in Northern Province of Rwanda: beneficiary and health worker perspectives.BMC pregnancy and childbirth · 2020Article
- Article
- Quality of care in prevention, detection and management of postpartum hemorrhage in hospitals in Afghanistan: an observational assessment.BMC health services research · 2020Observational
- Access and use of oxytocin for postpartum haemorrhage prevention: a pre-post study targeting the poorest in six Mesoamerican countries.BMJ open · 2020Article
- "We do what we can do to save a woman" health workers' perceptions of health facility readiness for management of postpartum haemorrhage.Global health action · 2020Article
- How to improve the quality of care for women with postpartum haemorrhage at Onandjokwe Hospital, Namibia: quality improvement study.BMC pregnancy and childbirth · 2019Article
- Quality of care in early detection and management of pre-eclampsia/eclampsia in health facilities in Afghanistan.BMC pregnancy and childbirth · 2019Article
- Quality of labor and birth care in Sindh Province, Pakistan: Findings from direct observations at health facilities.PloS one · 2019Article
- Effect of the competency-basedBMJ global health · 2019Article
- Screening and management of pre-eclampsia and eclampsia in antenatal and labor and delivery services: findings from cross-sectional observation studies in six sub-Saharan African countries.BMC pregnancy and childbirth · 2018Observational
- Improvement in the active management of the third stage of labor for the prevention of postpartum hemorrhage in Tanzania: a cross-sectional study.BMC pregnancy and childbirth · 2018Article
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9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the quality of facility-based active management of the third stage of labour in Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and the United Republic of Tanzania.
methodsBetween 2009 and 2012, using a cross-sectional design, 2317 women in 390 health facilities were directly observed during the third stage of labour. Observers recorded the use of uterotonic medicines, controlled cord traction and uterine massage. Facility infrastructure and supplies needed for active management were audited and relevant guidelines reviewed.
findingsMost (94%; 2173) of the women observed were given oxytocin (2043) or another uterotonic (130). The frequencies of controlled cord traction and uterine massage and the timing of uterotonic administration showed considerable between-country variation. Of the women given a uterotonic, 1640 (76%) received it within three minutes of the birth. Uterotonics and related supplies were generally available onsite. Although all of the study countries had national policies and/or guidelines that supported the active management of the third stage of labour, the presence of guidelines in facilities varied across countries and only 377 (36%) of 1037 investigated providers had received relevant training in the previous three years.
conclusionIn the study countries, quality and coverage of the active management of the third stage of labour were high. However, to improve active management, there needs to be more research on optimizing the timing of uterotonic administration. Training on the use of new clinical guidelines and implementation research on the best methods to update such training are also needed.
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