Uterotonics for prevention of postpartum haemorrhage: EN-BIRTH multi-country validation study

• DOI: 10.1186/s12884-020-03420-x
• Publication Date: 2021-03-26T00:06:05Z
• Authors: Harriet Ruysen; Josephine Shabani; Claudia Hanson; Louise T. Day; Andrea B. Pembe; Kimberly Peven; Qazi Sadeq-ur Rahman; Nishant Thakur; Kizito Shirima; Tazeen Tahsina; Rejina Gurung; Menna Narcis Tarimo; Allisyn C. Moran; Joy E. Lawn
• Keywords: Uterotonic; Postpartum haemorrhage

Abstract Background Postpartum haemorrhage (PPH) is a leading cause of preventable maternal mortality worldwide. The World Health Organization (WHO) recommends uterotonic administration for every woman after birth to prevent PPH. There are no standardised data collected in large-scale measurement platforms. Every Newborn Birth Indicators Research Tracking Hospitals (EN-BIRTH) an observational study assess the validity and newborn indicators, this paper reports findings regarding coverage quality uterotonics. Methods EN-BIRTH took place five hospitals Bangladesh, Nepal Tanzania, from July 2017 2018. Clinical observers tablet-based, time-stamped data. We compared observation uterotonics routine hospital register-records women’s report at exit-interview survey. analysed gap timing dose administration. register design was evaluated against analyses qualitative interview assessing barriers enablers recording use. Results Observed high all (> 99%, 95% CI 98.7–99.8%). Survey-report underestimated (79.5 91.7%). “Don’t know” replies varied (2.1 14.4%) were higher caesarean (3.7 59.3%). Overall, there low accuracy survey details (type timing). Register-recorded four capturing specific column (21.6, 64.5, 97.6, 99.4%). average 18.1% register-recorded 6.0% survey-reported coverage. Uterotonics given 15.9% women within “right time” (1 min) 69.8% 3 min. Women’s knowing purpose ranged 0.4 64.9% between hospitals. Enabling adequate staffing reported improve recording. Conclusions Routine registers have potential track – highly accurate two hospitals, consistently by survey-report. Although high, gaps observed dose. Standardisation implementation could flow into health management information reporting systems, requires further assessment.