title: Healthcare providers' knowledge and practices associated with postpartum hemorrhage during facility delivery in Dar es Salaam, Tanzania.
abstract: OBJECTIVE
  To investigate healthcare providers' knowledge and practices associated with prevention and management of postpartum hemorrhage (PPH) to improve care in urban settings and reduce maternal morbidity and mortality.
  
  
  METHODS
  As part of a cross-sectional, survey-based study, providers from 14 government health facilities providing maternal delivery services in the Ilala Municipality, Dar es Salaam, Tanzania, were surveyed about PPH-related practices and knowledge in April 2015. The data were analyzed descriptively, and χ2tests of independence were used to examine relationships between experience, facility type, and knowledge.
  
  
  RESULTS
  Among 115 respondents, 7 (6.1%) answered all PPH knowledge questions correctly. The mean knowledge score was 63.9%±21.1%. Non-calibrated methods for estimating postpartum blood loss were common; only 62 (53.9%) respondents reported direct collection. Referral of patients for PPH-related transfer was reported by 49 (42.6%) respondents; transportation and finances were barriers to transfer. Respondents requested continued training and additional supplies to address emergencies.
  
  
  CONCLUSIONS
  Healthcare providers had suboptimal knowledge of PPH risk factors, diagnosis, and causes. Strategies that provide ongoing education and equip lower-level facilities with adequate supplies might minimize PPH-related transfers. Providing prenatal women with basic delivery items (e.g. a blood collection device) and misoprostol is a viable option to ensure that essential PPH-prevention tools are available at delivery.
authors: Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: lcarna2@uic.edu.
authors: Leslie R
authors: LR
authors: Carnahan
authors: Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL, USA.
authors: Stacie E
authors: SE
authors: Geller
authors: School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors: Sebalda
authors: S
authors: Leshabari
authors: Amana Hospital, Ilala Municipality, Dar es Salaam, Tanzania.
authors: Willy
authors: W
authors: Sangu
authors: Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors: Bailey
authors: B
authors: Hanselman
authors: Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
authors: Crystal L
authors: CL
authors: Patil
mesh_terms: D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008428:Maternal Mortality; D008880:Midwifery / Q000193:education; D016595:Misoprostol / Q000627:therapeutic use; D010120:Oxytocics / Q000627:therapeutic use; D006473:Postpartum Hemorrhage / Q000517:prevention & control* / Q000628:therapy*; D011795:Surveys and Questionnaires; D013636:Tanzania
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: Facility delivery; Healthcare providers; Knowledge; Maternal morbidity; Maternal mortality; Midwives; Postpartum hemorrhage; Tanzania