{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T19:41:51Z","timestamp":1770061311535,"version":"3.49.0"},"reference-count":16,"publisher":"Global Health and Education Projects, Inc","content-domain":{"domain":["mchandaids.org"],"crossmark-restriction":true},"short-container-title":["Int J MCH AIDS"],"abstract":"<jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Maternal mortality, largely due to postpartum hemorrhage (PPH), remains high in resource-limited and crisis-affected settings, where heat-stable carbetocin (HSC) and tranexamic acid (TXA) offer promise for PPH prevention and treatment but lack evidence. This study, implemented in basic maternity facilities within humanitarian settings, explores healthcare providers\u2019 perspectives on an HSC and TXA-inclusive PPH intervention package and related operational challenges and facilitators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on semi-structured interview guides and using thematic analysis, this qualitative research, through 13 focus group discussions and individual interviews, investigated the perspectives of 64 healthcare staff (mostly midwives) from eight basic emergency obstetric care facilities in South Sudanese and Ugandan settings hosting large numbers of forcibly displaced populations. The PPH intervention package comprised refresher training, an online provider community, PPH readiness kits, alarm bells, and displayed algorithms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings from both countries converged, highlighting providers\u2019 positive views on HSC and TXA. HSC effectiveness in preventing bleeding was acknowledged, bolstering staff\u2019s confidence in its use. TXA was perceived as effective although providers reported having less experience with it due to the limited number of PPH cases. Enabling factors included the ease of administration, practical training, endorsement by national and local authorities, and the absence of a cold chain requirement. Appreciation was given to the WhatsApp community of practice as it facilitated knowledge exchange, quality improvement projects that enhanced PPH diagnosis, and innovative tools like wall clocks to record the timing of clinical actions and bells to call for assistance. Challenges included confusion between new and existing medications and record systems that inadequately capture HSC, TXA, and other PPH indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Global Health Implications<\/jats:title>\n                    <jats:p>HSC and TXA integrated into a PPH intervention package were overall positively valued by providers in humanitarian settings. Continued education and support are crucial. Addressing challenges like medication confusion underscores the need for ongoing education and clear guidelines for the use of HSC, TXA, oxytocin, and other drugs for PPH prevention and treatment. Our findings stress the importance of a comprehensive strategy to overcome health system barriers in PPH management, potentially improving maternal health outcomes in resource-limited and fragile contexts, with broader global implications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/ijma_7_2023","type":"journal-article","created":{"date-parts":[[2024,10,19]],"date-time":"2024-10-19T08:54:03Z","timestamp":1729328043000},"page":"S64-S71","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Postpartum Hemorrhage in Humanitarian Settings: Implementation Insights from Using Heat-Stable Carbetocin and Tranexamic Acid"],"prefix":"10.21106","volume":"13","author":[{"given":"Nguyen Toan","family":"Tran","sequence":"first","affiliation":[{"name":"Australian Center for Public and Population Health Research, Faculty of Health, University of Technology, Sydney, NSW, Australia"},{"name":"Faculty of Medicine, University of Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kidza","family":"Mugerwa","sequence":"additional","affiliation":[{"name":"United Nations Population Fund, Uganda Country Office UN House, Kololo, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Awatta Walter","family":"Ochan","sequence":"additional","affiliation":[{"name":"United Nations Population Fund, South Sudan Country Office UN House, Juba, South Sudan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Muwanguzi","sequence":"additional","affiliation":[{"name":"United Nations Population Fund, Uganda Country Office UN House, Kololo, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jemelia","family":"Sake","sequence":"additional","affiliation":[{"name":"United Nations Population Fund, South Sudan Country Office UN House, Juba, South Sudan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Mwesigwa","sequence":"additional","affiliation":[{"name":"United Nations Population Fund, Uganda Country Office UN House, Kololo, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okpwoku","family":"Sukere","sequence":"additional","affiliation":[{"name":"United Nations Population Fund, South Sudan Country Office UN House, Juba, South Sudan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catrin","family":"Schulte-Hillen","sequence":"additional","affiliation":[{"name":"United Nations Population Fund, Humanitarian Response Division, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"8847","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"10.25259\/IJMA_7_2023\/ref-1","article-title":"[Accessed 2023 Nov 01]. 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