KNOWLEDGE OF THE MANAGEMENT OF POSTPARTUM HAEMORRHAGE BY DOCTORS AND MIDWIVES WORKING IN FREE STATE DISTRICT HOSPITALS
DOI:
https://doi.org/10.25159/2520-5293/812Keywords:
knowledge, management, postpartum haemorrhage, district hospital, ESMOE, maternal mortality, maternity unitAbstract
Postpartum haemorrhage is a major cause of maternal mortality with an estimated annual occurrence of 13.8 million globally. In South Africa, postpartum haemorrhage accounted for above 73% of the 688 maternal deaths from obstetric haemorrhage during 2008–2010, with the majority occurring in district hospitals. This study seeks to determine the knowledge of doctors and midwives, working in maternity units of Free State district hospitals in postpartum haemorrhage management. In this cross-sectional study, self-administered questionnaires were completed by doctors and midwives working in the maternity units of 14 district hospitals in 2012/2013. In total, 132 participants were included in the analysis. The majority (64.1%) of the participants with known occupation (n=131) were midwives. The highest percentage (24.4%) of doctors were medical officers. Most (94.1%) participants had working experience of over one year to five years, and 44.2% had completed Essential Steps in the Management of Obstetric Emergencies (ESMOE). Only 40 participants (30.3%) obtained scores over 80%, the acceptable mark for core knowledge. Doctors performed significantly better than midwives (p=0.0002). ESMOE training resulted in significantly better performance (p=0.0045). Issues identified were inadequate overall theoretical knowledge and an inability to practically demonstrate acquired theoretical knowledge. The self-assessment of doctors on obstetrics-related surgical skills revealed insufficient practice. The overall theoretical knowledge of doctors and midwives working in the maternity units of Free State district hospitals is limited. The article recommends that the roll-out of the ESMOE training should include all midwives and doctors in maternity units at district hospitals. Adequate skills training and exposure to obstetric emergencies through rotation should also be encouraged for district hospital medical staff.
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Accepted 2016-05-26
Published 2016-10-04
