A condom uterine balloon device among referral facilities in Dar Es Salaam: an assessment of perceptions, barriers and facilitators one year after implementation

Abstract

Background: Postpartum hemorrhage (PPH) is the leading cause of maternal death in Tanzania. The Every Second Matters for Mothers and Babies-Uterine Balloon Tamponade (ESM-UBT) device was developed to address this problem in women with atonic uterus. The objective of this study was to understand the barriers and facilitators to optimal use of the device, in Dar es Salaam Tanzania 1 year after implementation. Methods: Semi-structured interviews of skilled-birth attendants were conducted between May and July 2017. Interviews were recorded, coded and analyzed for emergent themes. Results: Among the participants, overall there was a positive perception of the ESM-UBT device. More than half of participants reported the device was readily available and more than 1/3 described ease and success with initial use. Barriers included fear and lack of refresher training. Finally, participants expressed a need for training and device availability at peripheral hospitals. Conclusion: The implementation and progression to optimal use of the ESM-UBT device in Tanzania is quite complex. Ease of use and the prospect of saving a life/preserving fertility strongly promoted use while fear and lack of high-level buy-in hindered utilization of the device. A thorough understanding and investigation of these facilitators and barriers are required to increase uptake of the ESM-UBT device.

Every Second Matters ‐ uterine balloon tamponade implementation across ten medical colleges in Maharashtra and Madhya Pradesh in India: A qualitative study

“…Qualitative studies of ESM‐UBT use among providers in Tanzania, Kenya, Senegal, and Sierra Leone demonstrated that the device was widely accepted, easy to use, and helpful in managing refractory PPH and averting emergency hysterectomy. 17 , 18 , 19 , 20 Our findings are consistent with previous studies and support implementation of the ESM‐UBT package in tertiary referral centers and their networks. Our study contributes several key points to consider with future ESM‐UBT implementation in low‐resource settings.…”

“…This study contributes to a larger body of evidence supporting UBT use in a variety of settings. Qualitative studies of ESM‐UBT use among providers in Tanzania, Kenya, Senegal, and Sierra Leone demonstrated that the device was widely accepted, easy to use, and helpful in managing refractory PPH and averting emergency hysterectomy 17–20 . Our findings are consistent with previous studies and support implementation of the ESM‐UBT package in tertiary referral centers and their networks.…”

Introduction of the Ellavi uterine balloon tamponade into the Kenyan and Ghanaian maternal healthcare package for improved postpartum haemorrhage management: an implementation research study

“…Future studies should explore additional strategies to improve both implementation and service outcomes for the UBT. For example, improvements in training rates, fidelity to learnt methods and sustained use may be achieved with pre-service and in-service curriculums incorporating UBT devices, facility-based mentorship programmes supporting individual UBT-use, group refresher trainings (especially at low-volume facilities or where staff turnover is high), high-fidelity team practice simulations prior to emergency situations, advocacy for UBT use by local champions and Ministry of Health supervisor visits to monitor use and storage 7 36–39. Both Ghana and Kenya have illustrated a strong commitment to equip health providers with the proper tools to strengthen skills via training and supportive mentorship.…”

A novel solution for finding postpartum haemorrhage using fuzzy neural techniques

“…Daniel Surbek have analyzed, and conclusions were made by the Swiss PBM in obstetrics working group of experts in a consensus meeting [29]. Oluwakemi Adegoke developed the Every Second Matters for Mothers and Babies by using Uterine Balloon Tamponade (ESM-UBT) device which is used to control the blood to the uterus [30,31]. Marieke C. Punt [29] has revealed obstetric bleeding problems often occur in women with Inherited Platelet Receptor Defects (IPRD).…”