Active management of the third stage of labour: knowledge and challenges of obstetric caregivers in selected health facilities in Fako Division, Cameroon

Background: In Cameroon, the decrease in MMR (Maternal Mortality Ratio) from PPH (Postpartum Haemorrhage) despite reported use of the Active Management of the Third Stage of Labour (AMTSL) is slower than required to achieve the Third Sustainable Development Goal (SDG3) hence the need to question obstetric caregivers’ competence in AMTSL, as well as the factors hindering its proper useWe therefore aimed to assess obstetric caregivers’ knowledge about AMTSL, as well as the determinants and barriers of AMTSL in selected hospitals in Fako Division, Cameroon. Methods: This was a hospital-based cross-sectional study of 150 participants recruited in 27 health facilities in Buea, Limbe and Tiko health districts from January 15, 2020, to March 31, 2020. Participants’ socio-demographic and qualification characteristics, knowledge and challenges, and the references guiding their practice of AMTSL were collected using a structured questionnaire. AMTSL knowledge was categorized as poor or good and the determinants of good AMTSL knowledge were evaluated. The data was analyzed in SPSS version 25.0. Results: Of the 150 caregivers interviewed, only 48.7% had good knowledge of AMTSL. In logistic models, participants’ use of AMTSL increased Good knowledge of AMTSL (AOR: 12.96, CI: 1.12 -150.3, p =0.04). Unavailability of drugs and/or equipment, insufficient staff coverage and lack of knowledge and training of the staff were the major challenges reported. Conclusion: Obstetric caregivers in Fako division have knowledge gaps and face numerous challenges in AMTSL use, which could account for the consistently high MMR from PPH. Filling this knowledge gap and mitigating the challenges of these caregivers would certainly accelerate progress towards the achievement of SDG3.