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. 2020 Dec 11;17(24):9281. doi: 10.3390/ijerph17249281

Table 4.

Recommendations for improving PPH management in HFSUH, 2019.

SN Recommendations for Implementation
1. A PPH response team consisting of one obstetrician, one resident, three interns, and four midwives should be established, members need to be identified, rotation schedules made, and drills performed on regular basis.
2. A PPH kit (containing medications, supplies, checklists, and instruction cards) will be created and kept in the labor ward; PPH team responsible for stock out and completeness at all times.
3. PPH guidelines specifically for HFSUH need to be finalized and posters with standard PPH management criteria/steps to be put up in triage, the labor ward, and maternity ward.
4. PartoMa pocket guidelines for management of obstetric complications, as implemented in a study by Maaløe N et al. in Zanzibar [24], to be contextualized for use in HFSUH.
5. Documentation should be improved by implementing:

  • A PPH follow up chart (vital signs, blood loss, uterine status, fluid intake/output);

  • A PPH management checklist to be filled in after management and stabilization of patient, name of staff involved to be documented.
6. Sufficient blood should be made available through establishing a mini-blood bank for the maternity ward.
7. Punchers to be purchased to reduce incompleteness of patients’ cards and prevent loose sheets from getting lost.
8. Thirteen good quality blood pressure cuffs to be purchased, two for each room in the labor ward, one for triage.
9. An admission patient flow chart will be made and put up in the labor ward and triage, which includes who is responsible for what part of management in case of a new PPH admission.
10. Training with simulations for residents on B-lynch standard procedure and uterine artery ligation will be organized; PPH team responsible for organization.
11. Monthly presentation and meeting to discuss on what went well, what can be done better, and what actions to be taken to reach set objectives.

PPH—postpartum hemorrhage; HFSUH—Hiwot Fana Specialized University Hospital.