TITLE:
Active Management of the Third Stage of Labour: Knowledge and Challenges of Obstetric Caregivers in Selected Health Facilities in Fako Division, Cameroon
AUTHORS:
Tih William Ntchompbopughu, Egbe Obinchemti Thomas, Tendongfor Nicholas
KEYWORDS:
Active Management of the Third Stage of Labour, Postpartum Haemorrhage, Obstetric Caregivers, Knowledge, Challenges, Determinants
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.12,
December
30,
2021
ABSTRACT:
Background: In Cameroon, the decrease in MMR (Maternal Mortality Ratio) from PPH (Postpartum
Haemorrhage) despite the reported use of the Active Management of the Third Stage
of Labour (AMTSL) is slower than what is required to
achieve the Third Sustainable Development Goal (SDG3) hence the need to question
obstetric caregivers’ competence in AMTSL, as well as the factors hindering its
proper use. We therefore aimed to assess obstetric caregivers’ knowledge
about AMTSL, as well as the determinants and barriers of AMTSL in selected hospitals
in Fako Division, Cameroon. Methods: This was a hospital-based cross-sectional
study of 150 participants recruited in 27 health facilities in Buea, Limbe and Tiko
health districts from January 15, 2020, to March 31, 2020. Participants’ socio-demographic
and qualification characteristics, knowledge and challenges, and the references
guiding their practice of AMTSL were collected using a structured questionnaire.
AMTSL knowledge was categorized as poor or good and the determinants of good AMTSL
knowledge were evaluated. The data was analyzed in SPSS version 25.0. Results: Of the 150 caregivers interviewed, only 48.7% had good knowledge of AMTSL. In logistic
models, participants’ use of AMTSL increased Good knowledge of AMTSL (AOR: 12.96,
CI: 1.12 - 150.3, p = 0.04). Unavailability of drugs and/or
equipment, insufficient staff coverage and lack of knowledge and training
of the staff were the major challenges reported. Conclusion: Obstetric caregivers in Fako division have knowledge gaps and face numerous
challenges in AMTSL use, which could account for the consistently high MMR from
PPH. Filling this knowledge gap and mitigating the challenges of these caregivers would certainly accelerate progress towards the achievement of SDG3.