TABLE 1.

Overview of Key Findings About Future Uptake of a New Bundled Approach to PPH Detection and Management Across Data Sources and Countries

KenyaNigeriaSouth AfricaTanzaniaQES
InterviewsSurveyInterviewsSurveyInterviewsSurveyInterviewsSurvey
PPH detection
Use of a new measurement tool such as the calibrated drape will require staff being trained in how to use itAgreeNot foundAgreeNot foundAgreeNot foundNot foundNot foundNot found
The new measurement tool (calibrated drape) can accurately measure blood loss which consequently could result in more PPH being detectedAgreeNot foundAgreeNot foundAgreeNot foundNot foundNot foundNot found
Concerns about how the new measurement tool (calibrated drape) will fit in with current methods of collecting bloodAgreeNot foundAgreeNot foundAgreeNot foundNot foundNot foundNot found
PPH treatment
All components of the care bundle are part of current PPH management except tranexamic acid which is not routinely administeredAgreePartially AgreeAgreePartially AgreeAgreePartially AgreeNot foundPartially AgreeNot found
Training on using tranexamic acid is required particularly for midwives who currently may not administer IV medicationsAgreePartially AgreeAgreeAgreeAgreeDisagreeNot foundPartially AgreeNot found
Use of multiple interventions like in the PPH care bundle depends on having a large team available; one person cannot deliver the care bundleAgreeAgreeNot foundPartially AgreeAgreePartially AgreePartially AgreePartially AgreeNot found
Future uptake of a care bundle could be effective at changing how PPH is currently treated for vaginal birthsAgreePartially AgreeAgreePartially AgreeAgreePartially AgreeNot foundAgreeNot found
Overall use of a “bundled” approach to PPH treatment
Uptake of multiple interventions when treating PPH (e.g., MOTIVE bundle) will be challenging for staff to implement in the futureDisagreePartially AgreeDisagreePartially AgreeDisagreePartially AgreeNot foundPartially AgreeNot found
The uptake of MOTIVE bundle depends on the confidence of staff to deliver all components as a bundle, i.e., all at once or in quick successionNot foundNot foundPartially AgreeNot foundPartially AgreeNot foundNot foundNot foundNot found
Uptake of MOTIVE bundle relies on having sufficient staff on wards and having a reliable supply and consistent stock of the necessary drugs and equipmentAgreeAgreeAgreeAgreeAgreeAgreeAgreeAgreeAgree
The MOTIVE bundle to detect and treat PPH is likely to improve current management of vaginal births and reduce PPH-related mortalityAgreeAgreeAgreeAgreeAgreeAgreeNot foundAgreeNot found
  • Abbreviations: MOTIVE, massage of uterus, oxytocic drugs administration, tranexamic acid administration, intravenous fluids administration, examination for identifying and managing the source of bleeding, and escalation to more advanced care, if bleeding continues despite treatment; PPH, postpartum hemorrhage; QES, qualitative evidence synthesis.