INTRODUCTION

Background of the Study

Haemorrhage (bleeding) is a life threatening condition with high risk of

mortality and morbidity if prompt attention is not provided. Haemorrhage may

result from direct injury (mechanical) disease condition (pathological) or

pregnancy related (obstetrical).

According to Bailler’s Midwives Dictionary (2008) haemorrhage is an escape

of blood from its vessels either externally or within the body (internally).

Obstetric haemorrhage is a blood loss or bleeding during pregnancy labour or

within 42 days of termination of a pregnancy. It is one of the commonest single

cause of maternal mortality worldwide (Life Saving Skills Training Manual for

Nurses/Midwives (2005)).

Maternal mortality (maternal death or obstetric death) according to the World

Health Organization (WHO 2004) is the death of a woman while pregnant or

within 42 days of termination of pregnancy irrespective of the duration and site

of the pregnancy from any cause related to or aggravated by the pregnancy or

its management but not from accidental or incidental causes.

Approximately 342900 women die from complications of pregnancy and

childbirth annually and 99% of these deaths occur in developing countries

(Hogan et al 2008).

Globally for every 100000 live births about 251 women die (UNICEF 2011).

Many of the deaths occurs in women from the low-resource settings where the

women do not have easy access to health care facilities. Once the bleeding

commenced many women dies before reaching or receiving adequate treatment.

The Non-Pneumatic Anti-Shock Garment can be use to keep the women alive

until they can get treatment needed (Millers et al 2010).

WHO (2004) reveals that for every women who dies there are about 30 women

who suffers disability as a result of pregnancy or childbirth related

complications (a maternal morbidity) and 10 who experiences a “near miss”

morbidity (a life threatening obstetric complication).

Consequence report of maternal morbidity and mortality by the Commission on

Behavioural and Social Science and Education (CBBASSE 2000) is that

obstetric haemorrhage can lead to serious morbidities lifelong ailments which

compromise a woman’s life family health and ability to participate in

community life. If a woman dies after childbirth the newborn is ten times more

likely to die before the age of two other children are more likely to suffer from

inadequate nutrition and some may eventually drop out of school and asked to

go and stay with relatives.

Maternal and newborn deaths are estimated to cost the world $15 billion in lost

productivity annually with maternal health proven to support a country’s

economic growth and cut poverty (USAID 2011).

To overcome or reduce this unnecessary death the Non-Pneumatic Anti-Shock

Garment can be placed around the lower body of a woman who has gone into

shock from obstetric bleeding to reduce bleeding recovers the woman from

shock and keep her alive while transporting to a hospital or awaiting treatment

(Millers et al 2007).

The Non-Pneumatic Anti-Shock Garment (NASG) is a low-technological

first-aid device used to treat hypovalamic shock. Its efficacy for reducing

maternal deaths due to obstetric haemorrhage has being researched (Hogan

Margret et al 1980-2008). The Garment helps to reduce bleeding by 50% in

women with various forms of obstetric haemorrhage e.g. ruptured ectopic

pregnancy post-abortion complications post partum haemorrhage (Safe

Motherhood 2011).

The study therefore set out to determine the awareness of the use of

Non-Pneumatic Anti Shock Garment in maternity wards of government

hospitals in Ilorin metropolis.

Statement of the Problem

Maternal death and disabilities is a human right issue. It also means hardships

and loss of productivity to families communities and nations. This is of such

great concern that in year 2000 the world leaders decided that improving

maternal health should be one of the 8 Millennium Development Goals for the

International Community (WHO UNICEF UNFPA 2004).

The leading cause of maternal mortality (deaths from pregnancy and childbirth

related conditions) is obstetric haemorrhage most often immediately after birth

(WHO UNICEF UNFPA 2004).

To achieve the MDGs (improving maternal health) in our locality measures to

reduce maternal death and disability from obstetric haemorrhage should be our

priority.

Literature reveals that a woman dies from complication of obstetric bleeding

every 4 minutes. A woman can bleed to death in 2 hours or less especially in

rural areas where hospitals may be far away from them. Also in areas with

inadequate resources both human and materials to save the life of the woman

the women died while awaiting treatment (AMDD 2003).

Non-Pneumatic Anti-Shock Garment also known as LIFEWRAP has been

proved that women treated with the garment recovered much better than

women who were not treated with the garment (Millers 2008). To reduce

maternal mortality improve maternal health and promote family health as well

as improving their productivity to the community and the nation measures to

reduce obstetric complication should be embraced.

The research therefore is set out to determine the awareness of the use of

Non-Pneumatic Anti-Shock Garment among Nurses/Midwives in the maternity

wards of government hospitals in Ilorin metropolis.

Purpose of the Study

The purpose of this study is the awareness of the use of Non-Pneumatic

Anti-Shock Garment in the management of obstetric haemorrhage by

midwives/nurses working in government hospitals in Ilorin metropolis.

Specifically the purpose of this study is to:

1. Determine the availability of the resources for the use of anti-shock

garment in the health facilities.

2. Determine the method used for training nurses/midwives with the use of

anti-shock garment.

3. Determine the problems encountered by the nurses/midwives with the use

of anti-shock garment.

Significance of the Study

The result of the study will improve obstetric emergency care given to the

childbearing mother and thus reduce maternal mortality and extreme morbidity.

The outcome of the study will equip the nurses/midwives with new skills in

obstetric emergency care and also promote the standard of care given to the

childbearing women in our society.

The result of the study will be of benefit to the Kwara state government in

improving maternal health through various health reforms in order to reduce

maternal mortality in the state and Nigeria as a whole.

Research Questions

1. What are the resources available for the use of the Non-Pneumatic

Anti-Shock Garment in the health facilities?

2. What are the methods used in the training of nurses/midwives on the use

of Non-Pneumatic Anti-Shock Garment.

3. What are the problems encountered by the nurses/midwives in the use of

Non-Pneumatic Anti-Shock Garment.

Scope of the Study

The study focuses on obstetric haemorrhage prevalence causes outcome and

awareness of the use of Non-Pneumatic Anti-Shock Garment in the

management of emergency obstetric haemorrhage among nurses/midwives in

Government hospitals in Ilorin metropolis.