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Healthcare workers’ knowledge and attitude towards prompt referral of women with postpartum haemorrhage in Nigeria: a community-based study

Background: Postpartum Haemorrhage (PPH) is a major contributor to maternal mortality in developing countries most especially in the rural areas where Emergency Obstetric Care (EmOC) are not available. Delay in referring women from rural health facilities to settings where EmOC services are available have been reported. This study assessed community-based healthcare workers’ (CHWs) knowledge and attitude towards the prevention, early recognition and prompt referral of women with Post-Partum Haemorrhage (PPH) for Emergency Obstetric Care (EmOC).Methods: Descriptive cross-sectional design was used. Structured questionnaire was used to collect data from 200 CHWs recruited from community-based healthcare. Data analysis was done in SPSS version 20 at significance level of 0.05.Results: Findings show that 86.5% (n=173) of the respondents had good knowledge while 12% (n=24) and 1.5% (n=3) had moderate and poor knowledge respectively. Negative attitude towards prompt referral of women affected with PPH was found among 51% (n=102) of the respondents. Unavailability of blood drapes to estimate blood loss [χ2 (1, n=200) = 4.51, p=0.03], lack of ambulance [χ2 (1, n=200) = 4.46, p=0.03], and poor state of the roads [χ2 (1, n=200) = 4.44, p=0.03] were factors linked to poor attitude of CHWs towards prompt referral of affected women.Conclusions: The study concluded that there is a need for intervention that can help improve community healthcare workers’ attitude towards prompt referral of women affected with postpartum haemorrhage. There is also a need for general overhaul of community-based facilities to effectively support prompt referral.