ArticleBMJ global health2022
Effects of multifaceted interventions to prevent and manage primary postpartum haemorrhage in referral hospitals: a quasi-experimental study in Nigeria.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Clinical and healthcare systems-level interventions for postpartum hemorrhage prevention and management in Nigeria: a systematic review of effectiveness and implementation outcomes.Frontiers in health services · 2026Pooled it
- Outcome of interventions to improve the quality of intrapartum care in Nigeria's referral hospitals: a quasi-experimental research design.BMC pregnancy and childbirth · 2023Trial
- Commonest causes of maternal mortality in Nigeria: a situational report requiring an urgent action.Reproduction & fertility · 2026Review
- Heat-Stable Carbetocin in the Management of Postpartum Haemorrhage in Low- and Middle-Income Countries: A Comprehensive Review of Clinical Evidence, Cost-Effectiveness, Implementation Challenges and Adoption Strategies.International journal of women's health · 2025Review
- The Impact of Interaction Standard Theory-Based Multi-Care on Postpartum Recovery, Coping Styles, Psychological Distress, and Quality of Life in Women with Postpartum Hemorrhage.International journal of women's health · 2025Article
- Development of antepartum risk prediction model for postpartum hemorrhage in Lagos, Nigeria: A prospective cohort study (Predict-PPH study).International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2024Article
- Outcomes of a multifaceted intervention to prevent eclampsia and eclampsia-related deaths in Nigerian referral facilities.International health · 2024Article
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Authors and funding
10 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPrimary postpartum haemorrhage (PPH) is the leading cause of Nigeria's high maternal mortality rate. This study investigated the effectiveness of a set of multifaceted interventions to manage and reduce PPH in selected secondary referral health facilities in Nigeria.
methodsThis is a quasi-experimental study using an interrupted time-series design to assess a set of multifaceted interventions that address factors identified by stakeholders as associated with PPH. Interventions were implemented at two regional general hospitals, with a general hospital in the same region as the control. Intervention participants were women during antepartum and clinical and administrative staff. Cases of PPH were determined in women at delivery. The outcomes measured were the incidence of primary PPH and related deaths during the study period. Analyses included a comparative description of characteristics of the women, trend of time-series data at intervention and control hospitals, and multivariable analysis of factors associated with PPH occurrence.
resultsMonthly numbers of primary PPH were collected at participating hospitals over 21 months for 18 181 women. Intervention hospitals represent 54% vs 46% in control hospitals. Time-series analyses show a significant downward trend in intervention hospitals. The overall incidence of primary PPH was lower in the intervention hospitals than in the control hospitals. Multilevel regression adjusted for hospital-level effect showed a 68% reduction in odds of PPH cases at intervention compared with control hospitals. There were 12 PPH-related maternal deaths in one of the control hospitals, with no deaths in the intervention hospitals.
conclusionWe conclude that multiple interventions that address identified challenges in the prevention of primary PPH can potentially effectively reduce reported primary PPH in Nigerian referral hospitals. This approach is relevant for scaling the development of policies and programmes to prevent primary PPH and maternal mortality in Nigeria.
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