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Provider experience of uterine balloon tamponade for the management of postpartum hemorrhage in Sierra Leone
Author(s) -
Natarajan Abirami,
Kamara Jennifer,
Ahn Roy,
Nelson Brett D.,
Eckardt Melody J.,
Williams Anne Marie,
Kargbo Samuel A.,
Burke Thomas F.
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2015.10.026
Subject(s) - medicine , sierra leone , medical emergency , health care , health facility , nursing , surgery , health services , population , environmental health , economic growth , development economics , economics
Objective To understand healthcare providers' experience of incorporating uterine balloon tamponade (UBT) into the national postpartum hemorrhage (PPH) clinical pathway after UBT training. Methods In a qualitative study, semi‐structured interviews were undertaken with healthcare providers from 50 centers in Freetown, Sierra Leone, between May and June 2014. All eligible healthcare providers (undergone UBT training, actively conducted deliveries, and treated cases of PPH since UBT training) on duty at the time of center visit were interviewed. Results Sixty‐one providers at 47 facilities were interviewed. Bleeding was controlled in 28 (93%) of 30 cases of UBT device placement. Participants reported that UBT devices were easy to insert with only minor challenges, and enabled providers to manage most cases of uncontrolled PPH at their own facility and to refer others in a stable condition. Reported barriers to optimal UBT use included insufficient training and practical experience, and a scarcity of preassembled UBT devices. Facilitators of UBT use included widespread acceptance of UBT, comprehensive and enthusiastic training, and ready availability of UBT devices. Conclusion UBT—used either as a primary endpoint or en route to obtaining advanced care—has been well accepted and integrated into the national PPH pathway by providers in health facilities in Freetown.