| Sustainable scale-up of active management of the third stage of labor for prevention of postpartum hemorrhage in Ecuador. | |
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MedLine Citation:
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PMID: 22483573 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: To analyze the Ecuadorian experience regarding the adoption, scale-up, and institutionalization of active management of the third stage of labor (AMTSL) for prevention of postpartum hemorrhage via continuous quality improvement (CQI) processes. METHODS: Average AMTSL implementation rates for women with vaginal deliveries were compared using unweighted provincial aggregate data from facilities participating in 3 phases of AMTSL programming. Months taken to implement AMTSL at 80% or more and 90% or more compliance were compared across phases. RESULTS: Rate of oxytocin administration during the first 3months was 5.0% in phase 1, 9.8% in phase 2, and 72.2% in phase 3 (P≤0.001 vs phases 1 and 2). The average number of months provinces took to increase oxytocin administration to 80% or more and 90% or in more women with vaginal deliveries was, respectively, 21.6±18.7 and 30.6±16.4 in phase 1, 23.5±15.1 and 30.1±14.9 in phase 2, and 4.7±4.9 (P≤0.01 vs phase 1; P≤0.001 vs phase 2) and 4.0±3.4 (P≤0.001 vs phases 1 and 2) in phase 3. By December 2009, AMTSL implementation was sustained at 90% or more in all provinces. CONCLUSION: CQI processes identified resistance and operational barriers, and developed mechanisms to overcome them. |
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Authors:
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Jorge Hermida; Bernarda Salas; Nancy L Sloan |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-6 |
Journal Detail:
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Title: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Volume: - ISSN: 1879-3479 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0210174 Medline TA: Int J Gynaecol Obstet Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 International Federation of Gynecology and Obstetrics. All rights reserved. |
Affiliation:
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University Research Co., LLC, Bethesda, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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