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.
