Bulletin of the World Health Organization

Use of active management of the third stage of labour in seven developing countries

Cynthia Stanton, Deborah Armbruster, Rod Knight, Iwan Ariawan, Sourou Gbangbade, Ashebir Getachew, Jose Angel Portillo, Douglas Jarquin, Flor Marin, Sayoka Mfinanga, Jesus Vallecillo, Hope Johnson & David Sintasath

Volume 87, Number 3, March 2009, 207-215

Table 7. Crude odds ratios for four developing countries with at least 10% of births with correct use of active management of the third stage of labour,a by woman and facility characteristics, 2005 and 2006b

Characteristics Benin
 Ethiopia
 Honduras
 Indonesia
Odds ratio P- value Odds ratio P- value Odds ratio P- value Odds ratio P- value
Age of woman, in years
<20c 1.000 1.000 1.000 1.000
20–34 0.641 0.288 1.857 0.196 0.609 0.190 0.873 0.775
35+ 0.375 0.102 1.917 0.338 0.558 0.482 0.505 0.188
Parity
0 c 1.000 1.000 1.000 1.000
1 0.854 0.645 1.627 0.121 0.611 0.271 0.627 0.055
2 to 4 0.679 0.219 0.826 0.563 0.973 0.946 0.701 0.157
5+ 1.265 0.646 0.845 0.766 0.333 0.308 0.734 0.642
Provider qualification
Physicianc d 1.000 1.000 1.000
Midwife d 1.442 0.229 – 1.565 0.042
Nurse d 0.745 0.575 1.235 0.649 –
Other d 3.571e 0.0.18 2.754g 0.014 0.950f 0.867
Facility type
National referral hospitalc 1.000 1.000 1.000 1.000
Regional or provincial hospital 0.405 0.066 0.177 0.000 0.209 0.000 1.650 0.108
District hospital 0.645 0.336 0.558 0.086 0.368 0.001 1.218 0.488
Health centre or other 0.231 0.000 0.363 0.060 – –
In-service training for AMTSL: midwives
Noc 1.000 1.000 – 1.000
Yes 0.986 0.957 0.799 0.402 – 0.762 0.271
In-service training for AMTSL: nurses
Noc 1.000 1.000 1.000 1.000
Yes 4.096 0.225 0.408 0.006 1.121 0.428 0.918 0.736
In-service training for AMTSL: any physicians
Noc 1.000 1.000 1.000 1.000
Yes 1.211 0.563 4.800 0.000 0.272 0.000 0.871 0.492

AMTSL, active management of the third stage of labour.
a According to the Cochrane definition.
2
b Data collected from October to December 2005 for Ethiopia and the United Republic of Tanzania, and from July to December 2006 for the remaining countries.
c Reference category.
d In Benin, midwives assisted 94% of all deliveries; students assisted 5%.
e “Other” includes health assistants.
f “Other” includes medical students and one nurse.
g “Other” includes medical interns.