Why Don’t Providers Identify and Manage Maternal Sepsis? a Mixed-Methods Approach to Developing an Awareness Campaign to Accompany a WHO-Led Multi-Country Study

Abstract

Maternal sepsis continues to be one of the greatest contributors to maternal deaths globally. I explored the factors affecting healthcare provider awareness on maternal sepsis in order to better inform a campaign that accompanied a 53-country one-week inception cohort study validating a new definition for this condition. I used a mixed-method approach through semi-structured interviews with 13 study regional and country coordinators, and an online survey collecting responses from 1,071 providers from participating facilities. While 96% of the total sample had heard of maternal sepsis, few (19%) could correctly identify the two necessary criteria for defining it or the correct management of the condition (44%), even after controlling for provider age, qualifications, and region. exposure to training and an online congress were significantly associated with increased knowledge. More respondents were able to recognize essential resources needed for managing maternal sepsis, than there was for identifying it. Fear of making mistakes was one of the main barriers for correct and timely decision-making. Self-confidence and institutional support were low, despite the perception of availability of specific protocols and exposure to training. While most respondents situated maternal sepsis as one of the top conditions affecting women, the majority only saw this occurring in less than 11% of deliveries in their facilities. The results of my project indicate that research studies would benefit from including awareness campaigns as part of their main objectives. In addition to helping attain the overarching research goal, they can also help in obtaining buy-in, and developing and strengthening a sense of community among providers of large multi-country studies.