ACTIVE MANAGEMENT OF THIRD STAGE OF LABOR PRACTICE AND ASSOCIATED FACTORS AMONG OBSTETRIC CARE PROVIDERS AT PUBLIC HEALTH INSTITUTIONS IN KEMBATA TEMBARO ZONE AND ALABA TOWN SOUTHERN ETHIOPIA

Abstract

Background: Active management of the third stage of labor (AMTSL) is a combination of actions performed during the third stage of labor to prevent PPH. More than half a million women die every year of complications related to pregnancy or childbirth. Haemorrhage was the leading direct cause of maternal death worldwide; representing approximately one third of maternal deaths. It was estimated that annually 1.4 million deliveries do not receive correct active management of the third stage of labour. Objectives: To assess active management of third stage of labor practice and associated factors among obstetric care providers at public health institutions in Kembata Tembaro zone and Alaba town southern Ethiopia Methods: Institutional based cross-sectional study was employed among randomly selected 171 obstetric care providers from January 20 through February 28, 2018. Questionnaire and checklist were used to collect data. Frequencies, proportion, and summary statistics were used to describe the study population and presented in tables. Bivariate analysis was carried out to identify factors that are associated with practice of active management of third stage of labor. Multivariate logistic regression analysis was performed for those factors that showed a statistically significant association in bivariate by controlling for possible confounders. Association between outcome and independent variable was presented by crude and adjusted odds ration with 95% CI. Result: Of the 171 obstetric care providers 29.8% have good practice to manage third stage of labor. Pre/in service training (AOR=4.760; 95% CI: 1.893-11.968 ), service year (AOR=2.514; 95%CI: 1.067-5.927) and knowledge towards active management of third stage of labor (AOR=4.882; 95%CI: 2.103-11.336 ) were the major factors associated with proper active management of third stage of labor. Conclusion: the level of good practice was low. The practice of obstetric care providers can be improved with appropriate interventions like in-service trainings. This study also clearly showed that the level of good practice towards active management of third stage of labor needs immediate attention of zone health bureau to arrange trainings and to avail standard document for their obstetrics care providers. This enhances skill of obstetric care providers.