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Healthcare Provider Perceived Competency in Postpartum Hemorrhage Management: Insights from a Quantitative Survey in Ugandas National Referral Facility

Steven, B.; Mike, K. N.; Obore, S.

2025-06-11 obstetrics and gynecology
10.1101/2025.06.10.25329371 medRxiv
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BackgroundPostpartum hemorrhage (PPH) remained a significant global health challenge, affecting over 14 million women annually and causing approximately 70,000 maternal deaths worldwide. This study assessed the perceived competency of healthcare providers in managing postpartum hemorrhage at Kawempe National Referral Hospital. MethodsA facility-based cross-sectional study was conducted at Kawempe National Referral Hospital using quantitative data collection methods. The study population comprised 221 obstetric healthcare providers, including 96 midwives, 20 nurses, 18 medical intern doctors, 73 residents in obstetrics and gynecology, and 14 specialists. Data were collected using a pretested structured interviewer-administered questionnaire, and healthcare practices were assessed using the E-MOTIVE bundle. Data analysis was performed using STATA version 18. Logistic regression analysis was conducted to test associations between dependent and independent variables, with a P-value <0.05 considered statistically significant. ResultsThe study revealed that 81% of healthcare providers demonstrated good knowledge of PPH management, and 61% were confident in their ability to manage PPH. However, only 39.8% of the participants were deemed competent in PPH management. The study found a positive association between specialized training and competence, with HCWs who had received multiple PPH-related training sessions more likely to be competent. Factors such as being a specialist and having received focused training on active management of the third stage of labor were significantly associated with higher competence levels. ConclusionThe study concluded that while knowledge and confidence in managing PPH were generally high among healthcare providers at Kawempe National Referral Hospital, there was a gap in practical competence. Specialized training in PPH management was a significant predictor of competence, underscoring the importance of targeted, hands-on education. The findings suggest that improving training opportunities and resources, particularly in rural and underserved areas, could enhance the overall competence of healthcare providers in managing PPH, ultimately improving maternal health outcomes.

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