Effects of multifaceted interventions to prevent and manage primary postpartum haemorrhage in referral hospitals
A quasi-experimental study in Nigeria
Bibliographic Data
| ID | 21879042 |
|---|---|
| Authors | Friday Okonofua (0000-0002-8777-2606, Social Action, corresponding author), Friday Ebhodaghe Okonofua (Women's Health and Action Research Centre, Benin City, Nigeria), Bola F Ekezue (0000-0001-8305-065X, Fayetteville State University), Lorretta Ntoimo (0000-0002-3218-5535, Social Action), Chioma Ekwo (0000-0002-9840-2117, Social Action, corresponding author), Victor Ohenhen (0000-0001-6311-7239, University of Benin Teaching Hospital), Kingsley Agholor (0000-0002-6596-3671, Federal Medical Centre), Brian Igboin (0000-0002-3241-6110, Social Action), Wilson Imongan (0000-0001-7734-0626, Social Action), Hadiza Galadanci (0000-0001-5810-2884, Bayero University Kano), Rosemary Ogu (0000-0002-5467-302X, University of Port Harcourt) |
| Year | 2022 |
| Volume | 7 |
| Issue | 4 |
| Pages | e007779 |
| Publication date | 2022-04-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2021-007779 |
| PMID | 35443937 |
| OpenAlex | W4224286898 |
| Language | EN |
| References cited | 22 |
INTRODUCTION: Primary 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. METHODS: This 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. RESULTS: Monthly 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. CONCLUSION: We 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
Family medicine · Interrupted time series · Interrupted Time Series Analysis · Odds ratio · Psychological intervention · Referral · Global Maternal and Child Health · Maternal and fetal healthcare · Medicine · Nursing · Pregnancy and preeclampsia studies · Emergency Medicine · Pediatrics
| Highly cited | No |
|---|