• Contents of device: syringe with a Luer lock valve, condom, Foley catheter with cotton string | |
• Training and curriculum materials: PPH-UBT job aid checklist, a wall poster, PPH clinical pathway guide, a trainer’s flipchart, and a learner’s booklet | |
• Trainees were instructed to use the UBT within the context of the established national protocol for PPH, which first included active management of the third stage of labor: • uterine massage • emptying the bladder • breastfeeding (if feasible) • identifying and treating perineal or cervical tears • administering prophylactic oxytocin and/or misoprostol (or other uterotonics if available) • manual removal of the placenta and blood clots • placement of the uterine balloon should occur if these interventions fail | |
• Training-of-trainers model: the training program was a participatory, skills-based training that used hands-on PPH scenarios and simple maternal uterine models made of local components (e.g. a pillow surrounding a plastic water bottle, which represented a uterus within an abdomen) | |
• Trainees were representative maternal health providers from each facility and were brought to a regional location for initial training. | |
• These providers then returned to their facilities and trained staff with the target of ensuring that at least 85% of maternity providers in each facility achieved competence in UBT placement (defined as ‘online’ status). | |
• All facilities received one wall chart checklist per delivery room, two manuals for PPH management and UBT use, and an adequate number of pre-deviced ESM-UBT kits (i.e. device and checklist). |