El Salvador - Active Management of the Third Stage of Labor - POPPHI

Supplies and logisticsThe sufficient availability of high-quality uterotonic drugs, needles, and syringes at national andlocal levels is essential for routine use of AMTSL. Effective use of AMTSL also requiresappropriate conditions during transport and storage to ensure the use of chemically-active drugsand safe, sterile needles and syringes.Figure 1.1. Determinants of the routine use of AMTSL.PolicyProviderHistoricalprecedent,influence ofleader,WHO,in-servicetrainingNationalguidelinesPresence inpre-servicetrainingKnowledge,skills inAMTSLAMTSLprotocolin hospital“Champions” foruse of AMTSLMotivationto useExpectedbehaviorin hospitalImplementationProperstorageWomanreceivesAMTSLLogisticsUterotonicsincluded onEssentialDrug List(oxytocin=drug ofchoice)SufficientamountprocuredTransportissuesProcurementat hospitallevelAvailabilityof sufficientoxytocics,needles,syringe on siteThe aim of this study is to provide ministries of health (MOHs) and their international partnerswith the descriptive information necessary to assess AMTSL practices and identify majorbarriers to its use. The findings will inform interventions that improve adoption andimplementation of AMTSL.The study’s specific research questions are as follows:1. For what proportion of deliveries is AMTSL used at a national level? Which components ofAMTSL (e.g., prophylactic use of oxytocic agents, controlled cord traction, and fundalmassage) are practiced, and how consistently are they practiced?2. Is AMTSL formally promoted in the Standard Treatment Guidelines (STGs) in each countryat national and/or facility levels? If so, since when? How is AMTSL defined in thestandards?3. How is the need for AMTSL drugs quantified at national and facility levels?4. Which uterotonic drug (e.g., oxytocin, ergometrine, or a prostaglandin) is used? How is itstored?5. At the facility level, is enough oxytocin available to allow for routine use of AMTSL?6