{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:33:08Z","timestamp":1773005588721,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T00:00:00Z","timestamp":1766707200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004102","name":"Laerdal Foundation for Acute Medicine","doi-asserted-by":"publisher","award":["2023\u20100124"],"award-info":[{"award-number":["2023\u20100124"]}],"id":[{"id":"10.13039\/501100004102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Postpartum haemorrhage, an excessive bleeding after childbirth, remains a leading cause of maternal mortality in low\u2010resource settings. Improving the quality of postpartum haemorrhage care using audit and embedded quality improvement is essential for addressing this. A criteria\u2010based audit, an objective, systematic and critical analysis of the quality of health care against a set of criteria, is essential for identifying appropriateness of care and areas for improvement in postpartum haemorrhage management. The aim of this study was to audit management of postpartum haemorrhage as quality assessment for postpartum haemorrhage care in a tertiary university hospital in eastern Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In 2023, we repeated the criteria\u2010based audit cycle conducted in 2019 to re\u2010evaluate management of postpartum haemorrhage using the same previously co\u2010created\n                      <jats:italic>eight<\/jats:italic>\n                      audit criteria. Two midwives and one consultant obstetrician independently reviewed each woman's medical records to assess whether a criterion was met or not. Findings were compared with the 2019 reports using a chi\u2010square test and discussed with birth attendants and administrators of the hospital to identify underlying factors and areas for improvement in postpartum haemorrhage care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 55 medical records reviewed, fulfilment of the audit criteria ranged from 24% (13\/55) for fluid input and output monitoring to 100% (55\/55) for documenting woman's history and general clinical conditions at admission, and haemoglobin measurement. Compared with the previous audit, where only 6.7% (3\/45) women met all the audit criteria, there was substantial increase in proportion\u00a0in the current audit as 22% (12\/55) cases met all the criteria (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Lack of template for a postpartum haemorrhage management, refresher training, postpartum haemorrhage emergency kit, adherence to postpartum haemorrhage management guideline and adequate blood for transfusion were identified as major barriers to providing optimal postpartum haemorrhage care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Just over one in five women met the local audit criteria for postpartum haemorrhage management, and major barriers to providing the best possible care persist. These results highlights the need to develop a postpartum haemorrhage management template, availing blood for transfusion, providing low\u2010dose high frequency (refresher) training and drills for staff, and enhancing documentation and record keeping in the hospital for improving quality of postpartum haemorrhage management to stop preventable deaths and sequelae from postpartum haemorrhage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70069","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T07:18:17Z","timestamp":1766819897000},"page":"307-314","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using Criteria\u2010Based Audit to Improve the Management of Postpartum Haemorrhage in a University Hospital in Eastern Ethiopia: A Before and After Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3858-190X","authenticated-orcid":false,"given":"Sagni","family":"Girma","sequence":"first","affiliation":[{"name":"College of Health and Medical Sciences, Haramaya University  Harar Ethiopia"},{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Centre  Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Centre  Leiden the Netherlands"},{"name":"Athena Institute, Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos","family":"van Roosmalen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Centre  Leiden the Netherlands"},{"name":"Athena Institute, Vrije Universiteit Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semir Sultan","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Haramaya University Hiwot Fana Comprehensive Specialized Hospital  Harar Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Redwan","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Haramaya University Hiwot Fana Comprehensive Specialized Hospital  Harar Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seble","family":"Mengistu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Haramaya University Hiwot Fana Comprehensive Specialized Hospital  Harar Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamirat","family":"Getachew","sequence":"additional","affiliation":[{"name":"College of Health and Medical Sciences, Haramaya University  Harar Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abera Kenay","family":"Tura","sequence":"additional","affiliation":[{"name":"College of Health and Medical Sciences, Haramaya University  Harar Ethiopia"},{"name":"Department of International Public Health Liverpool School of Tropical Medicine  Liverpool UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00385-9"},{"key":"e_1_2_11_3_1","volume-title":"Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division","author":"World Health Organization","year":"2023"},{"key":"e_1_2_11_4_1","unstructured":"World Health Organization \u201cTrends in Maternal Mortality 2000 to 2023: Estimates by WHO UNICEF UNFPA World Bank Group and UNDESA\/Population Division \u201d 2025."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02290-0"},{"key":"e_1_2_11_6_1","volume-title":"WHO Recommendations: Uterotonics for the Prevention of Postpartum Haemorrhage","author":"World Health Organization","year":"2018"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.11.04048"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.03.001"},{"key":"e_1_2_11_10_1","volume-title":"National Maternal and Perinatal Death Surveillance and Response (MPDSR) System Annual Report 2012 EFY; Addis Ababa","author":"Ethiopian Public Health Institute","year":"2020"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12735"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-024-03986-4"},{"key":"e_1_2_11_13_1","unstructured":"United Nations \u201cThe Sustainable Development Goals Report 2019. United Nations Department of Economic and Social Affairs \u201d 2019 https:\/\/digitallibrary.un.org\/record\/3812145?ln=en&v=pdf."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)90226-7"},{"issue":"5","key":"e_1_2_11_15_1","first-page":"614","article-title":"Criteria for Clinical Audit of the Quality of Hospital\u2010Based Obstetric Care in Developing Countries","volume":"78","author":"Graham W.","year":"2000","journal-title":"Bulletin of the World Health Organization"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(01)00427-1"},{"key":"e_1_2_11_17_1","unstructured":"P.Bailey J.Fortney L.Freedman et\u00a0al. \u201cImproving Emergency Obstetric Care Through Criterion\u2010Based Audit \u201d 2002."},{"issue":"7427","key":"e_1_2_11_18_1","first-page":"1329","article-title":"Introducing Criteria Based Audit Into Ugandan Maternity Units","volume":"327","author":"Weeks A. D.","year":"2003","journal-title":"BMJ (Clinical Research Ed)"},{"issue":"3","key":"e_1_2_11_19_1","first-page":"59","article-title":"Evaluation of Criteria\u2010Based Clinical Audit in Improving Quality of Obstetric Care in a Developing Country Hospital","volume":"12","author":"Hunyinbo K. I.","year":"2008","journal-title":"African Journal of Reproductive Health = La Revue Africaine de la Sant\u00e9 Reproductive"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-8-190"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0408-3"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzr042"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1219-y"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17249281"},{"key":"e_1_2_11_25_1","volume-title":"Beyond the Numbers: Reviewing Maternal Deaths and Complications to Make Pregnancy Safer","author":"World Health Organization","year":"2004"},{"key":"e_1_2_11_26_1","volume-title":"National Guideline on Prevention and Management of Postpartum Haemorrhage","author":"Federal Ministry of Health of Ethiopia","year":"2022"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-22-00281"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.15240"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1183\/20734735.018016"},{"issue":"7","key":"e_1_2_11_30_1","first-page":"442","article-title":"Postpartum Haemorrhage: Prevention and Treatment","volume":"95","author":"Evensen A.","year":"2017","journal-title":"American Family Physician"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-16-00143"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2303966"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2012-000823"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70069","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.70069","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:09:32Z","timestamp":1772996972000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.70069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,26]]},"references-count":32,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/tmi.70069"],"URL":"https:\/\/doi.org\/10.1111\/tmi.70069","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,26]]},"assertion":[{"value":"2025-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}