Effects of the Helping Mothers Survive Bleeding after Birth training on near miss morbidity and mortality in Uganda: A cluster-randomized trial.
Int J Gynaecol Obstet
; 152(3): 386-394, 2021 Mar.
Article
en En
| MEDLINE
| ID: mdl-32981091
ABSTRACT
OBJECTIVE:
To assess the effect of Helping Mothers Survive Bleeding after Birth training on postpartum hemorrhage (PPH) near miss and case fatality rates in Uganda.METHODS:
Training was evaluated using a cluster-randomized design between June 2016 and September 2017 in 18 typical rural districts (clusters) in Eastern and Central Uganda of which nine districts were randomly assigned to the intervention. The main outcome was PPH near miss defined using the World Health Organization's disease and management-based approach. Interrupted time series analysis was performed to estimate the difference in the change of outcomes.RESULTS:
Outcomes of 58 000 and 95 455 deliveries during the 6-month baseline and 10-month endline periods, respectively, were included. A reduction of PPH near misses was observed in the intervention compared to the comparison districts (difference-in-difference of slopes 4.19, 95% CI, -7.64 to -0.74); P<0.05). There was an increase in overall reported near miss cases (difference-in-difference 1.24, 95% CI, 0.37-2.10; P<0.001) and an increase in PPH case fatality rate (difference-in-difference 2.13, 95% CI, 0.14-4.12; P<0.05).CONCLUSION:
This pragmatic cluster-randomized trial conducted in typical rural districts of Uganda indicated a reduction of severe PPH cases while case fatality did not improve, suggesting that this basic training needs to be complemented by additional measures for sustained mortality reduction. TRIAL REGISTRATION PACTR201604001582128.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Atención Prenatal
/
Evaluación de Resultado en la Atención de Salud
/
Potencial Evento Adverso
/
Hemorragia Posparto
/
Capacitación en Servicio
/
Servicios de Salud Materna
Tipo de estudio:
Clinical_trials
Límite:
Adult
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Female
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Humans
/
Pregnancy
País/Región como asunto:
Africa
Idioma:
En
Revista:
Int J Gynaecol Obstet
Año:
2021
Tipo del documento:
Article
País de afiliación:
Suecia