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

Abstract

India has made tremendous progress in reducing maternal mortality, lowering the maternal mortality ratio by over 50% between 2004-2006 and 2016-2018. 1,2 Postpartum hemorrhage (PPH) is the leading cause of maternal death in India, accounting for between 19.9% and 38% of maternal deaths annually. 3,4 Many cases of PPH can be effectively managed with low-cost solutions such as active management of the third stage of labor and uterotonics. 5,6 However, in refractory cases, high-resource surgical interventions such as uterine artery ligation, B-lynch sutures, or hysterectomy may be necessary.

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.…”

Feasibility and impact of a postpartum hemorrhage emergency care package using a bundle approach in Migori County, Kenya

“…The interview guide was adapted from Burke and colleagues, 14 a qualitative analysis of the Every Second Matters Uterine Balloon Tamponade intervention in India in March 2020. Additionally, we integrated questions from the Consolidated Framework For Implementation Research 15 .…”

“…The PPH EmC package is a comprehensive initiative developed by senior obstetricians/gynecologists and maternal health champions around the world in collaboration with the Massachusetts General Hospital Global Health Innovation Laboratory. The aim of PPH EmC is to deliver high-quality obstetric care by optimizing provider response and strengthening overall health system function through clinical (Figure 2) and non-clinical (Figure 3 The interview guide was adapted from Burke and colleagues, 14 a qualitative analysis of the Every Second Matters Uterine Balloon Tamponade intervention in India in March 2020. Additionally, we integrated questions from the Consolidated Framework For Implementation Research.…”