Abstract:
: Postpartum hemorrhage is a worldwide problem of maternal morbidity and
mortality. Proper and effective use of active management of the third stage of labor prevents
postpartum hemorrhage by 60%-70%. However, information was scarce regarding the practice
of active management third stage of labour and its contributing factors in the study area.
Objective: To assess practice and factors associated with active management of the third stage
of labor among obstetric care providers in public health facilities in Eastern Ethiopia.
Methods: An institution-based cross-sectional study design was applied among randomly
selected 258 obstetric care providers from July 15 - October 15/2021. A self-administered
structured questionnaire and observational checklist were used to collect the data. The data were
coded, cleaned, and entered into Epi-data 4.6 and exported to SPSS 25 for analysis. Data were
presented in percentage, proportion, mean, and odds ratio. In bivariable analysis, variables
having a p-value less than 0.25 were considered for multivariable analysis. Then adjusted odds
ratio 95% confidence interval was carried out to estimate the effect of independent variables on
the practice of active management third stage of labour. Statistical significance was declared at
a p-value of less than 0.05.
Results: Among 258 study participants, 40.3% [95% CI: (34.5%-46.1%)] of the obstetric care
providers had good practice on active management third stage of labor. Being Trained
[AOR=3.02; 95% CI: (1.60, 5.70)], presence of birth assistant [AOR= 2.9; 95% CI: 1.42, 6.04)],
having highest educational level [AOR= 4.21; 95% CI: (1.08,16.40)], and having good
knowledge [AOR=3.00; 95% CI:(1.45-6.20)] were statistically associated with good practice of
active management third stage of labour.
Conclusion: This finding portrayed a low level of obstetric care providers' practice on active
management of the third stage of labor. It urges health practitioners, programmers, and policy
makers to devise a mechanism in enhancing the practice to the level of expectation. Training,
educational level, availability of birth assistance, and knowledge were significantly associated
factors. So, strengthening the presence of birth assistants at all deliveries, emphasizing
education, and updating the obstetric care providers through comprehensive and on-the-job
training are important measures to decrease the problem.
Keywords: Practice, Active management third stage, obstetric care provider, easte
