ArticleReproductive health2018
Implementation project of the non-pneumatic anti-shock garment and m-communication to enhance maternal health care in rural Tanzania.
Article in Reproductive health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 5 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 5 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Systematic review of the barriers and facilitators to the implementation of non-pneumatic antishock garments in low- and middle-income countries: lessons for global health.BMJ global health · 2025Pooled it
- Non-pneumatic anti-shock garment utilization and associated factors in Ethiopia: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2025Pooled it
- Nonpneumatic anti-shock garment utilization for obstetric hemorrhage management and its predictors among obstetric care providers in Ethiopia: a systematic review and meta-analysis.BMC health services research · 2024Pooled it
- Perceptions and experiences of the prevention, detection, and management of postpartum haemorrhage: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2023Pooled it
- Pooled it
- Digital Health Interventions in Emergency Obstetric and Newborn Care Services in Low- and Middle-Income Countries: Scoping Review.Journal of medical Internet research · 2025Article
- Utilization of non-pneumatic anti-shock garment for the management of obstetric hemorrhage among healthcare providers in north Shewa zone, Ethiopia.Frontiers in public health · 2023Article
- FIGO recommendations on the management of postpartum hemorrhage 2022.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2022Article
- Training facilitated by interinstitutional collaboration and telemedicine: an alternative for improving results in the placenta accreta spectrum.AJOG global reports · 2021Article
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundObstetric hemorrhage (OH) remains one of the leading causes of maternal mortality, particularly in rural Africa. Tanzania has a high maternal mortality ratio, and approximately 80% of the population accesses health care lower level facilities, unable to provide Comprehensive Emergency Obstetric Care (CEmOC). The non-pneumatic anti-shock garment (NASG) has been demonstrated to reduce mortality as it buys time for women in shock to be transported to or to overcome delays at referral facilities.
methodsThis report describes one component of an ongoing maternal health improvement project, Empower, implemented in 280 facilities in four regions in rural Tanzania. The NASG along with a Closed User Group (CUG) mobile phone network were implemented within the overall EmOC project. Simulation trainings, repeated trainings, and close hands-on supportive supervision via site visits and via the CUG network were the training/learning methods. Data collection was conducted via the CUG network, with a limited data collection form, which also included free text options for project improvement. One-to-one interviews were also conducted. Outcome Indicators included appropriate use of NASG for women with hypovolemic shock We also compared baseline case fatality rates (CFR) from OH with endline CFRs. Data were analyzed using cohort study Risk Ratio (RR). Qualitative data analysis was conducted by content analysis.
resultsOf the 1713 women with OH, 419 (24.5%) met project hypovolemic shock criteria, the NASG was applied to 70.8% (n = 297), indicating high acceptability and utilization. CFR at baseline (1.70) compared to CFR at endline (0.76) showed a temporal association of a 67% reduced risk for women during the project period (RR: 0.33, 95% CI = .19, .60). Qualitative feedback was used to make course corrections during the project to enhance training and implementation.
conclusionsThis implementation project with 280 facilities and over 1000 providers supported via CUG demonstrated that NASG can have high uptake and appropriate use for hypovolemic shock secondary to OH. With the proper implementation strategies, NASG utilization can be high and should be associated with decreased mortality among mothers at risk of death from obstetric hemorrhage.
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