African Health Sciences
Makerere University Medical School
Vol. 20, No. 4, 2020, pp. 1908-1917
Bioline Code: hs20155
Full paper language: English
Document type: Research Article
Document available free of charge
African Health Sciences, Vol. 20, No. 4, 2020, pp. 1908-1917
© Copyright 2020 - Ramadhani FB et al.
Knowledge and barriers on correct use of modified guidelines for active management of third stage of labour: a cross sectional survey of nurse-midwives at three referral hospitals in Dar es Salaam, Tanzania|
Ramadhani, Fatina B; Liu, Yilan & Lembuka, Melania Menrad
Background: Despite the fact that it is possibly preventable, postpartum haemorrhage (PPH) is the global most deadly
form of obstetric bleeding, mainly sub-Saharan Africa with at least one-fourth of maternal deaths in East African regions.
Active management of third stage of labour (AMTSL) is recommended to prevent PPH. However, AMTSL guidelines have
been revised since 2006.
Objectives: To examine the current status of nurse-midwives’ knowledge on modified AMTSL guidelines and highlight
barriers to AMTSL correct use.
Method: Descriptive cross sectional survey was conducted to 160 nurse-midwives at three referral hospitals in Dar es Salaam,
Tanzania. One-way, interactive modes ANOVA and Chi square (χ2) test were run in SPSS 21 version to compare the
association of independent and dependent variables.
Results: Virtually all nurse-midwives knew the first recommended uterotonic (99.4%) and delayed cord clamping (98.8%)
protocols as modified. Knowledge was significantly contributed by multiple factors; p=0.001. Reported correct AMTSL use
was 46.8% which was significantly affected by AMTSL training (χ2 = 6.732, p = 0.009) and prioritizing atteding an asphyxiated
baby (χ2 = 5.647, p = 0.017).
Conclusion: Regardless of high nurse-midwives’ AMTSL knowledge; it is imperative that responsible authorities plan appropriate
strategies to solve reported barriers affecting correct AMTSL use.
Nurse-midwives’ knowledge; maternal bleeding; maternal mortality; third stage of labour; AMTSL; atonic uterus.