Implementation report of a pilot study in two regions of Madagascar: An innovative approach to strengthen provider capacity for the prevention and treatment of postpartum hemorrhage at frontline facilities

Summary

This pilot study was designed to explore the utility, acceptability, and feasibility of a novel approach to strengthen provider capacity for the prevention, identification and management of PPH, in two regions of Madagascar. The components of the approach include: 1. Mentorship model using Virtual Mentor and Simulation to optimally prevent and manage PPH, including mentor visits to basic health centers (CSBs) to facilitate PPH simulation practice combined with a mobile decision support tool called Virtual Mentor; and 2. Enhancing the clinical environment to optimize provider behaviors by introducing new provider support tools, including a glow-in-the-dark PPH algorithm poster, task badges for delegating important support roles during childbirth to members of the family, a custom timer to encourage timely administration of the preventative dose of oxytocin immediately after birth, and an activity during the introduction of the tools to help providers visualize each woman’s risk for PPH and its consequences. This report describes the implementation process of the 2020 APPHC pilot study. A separate report details measurement and analysis of outcomes results.