Back 10 November 2017

Preventing PPH: Saving lives of mothers and babies

In an effort to improve and accelerate progress on reduction of maternal, newborn and child death in Tanzania; Alex James, a midwife and midwifery educator designed a project to save the lives of mothers and their newborns, especially in the rural areas. 

Ales James receiving award 2017

Alex James receiving the Global Education award during the 31st ICM Midwifery Triennial Congress in Toronto, JUne 2017

Alex’s project entitled “Stop Postpartum Hemorrhage (PPH) Active Management of third stage of labor to Save Lives of Mothers and their Babies” won the International Confederation of Midwives (ICM) and Johnson and Johnson Global Education Award on midwifery. The award is an encouragement and example for midwifery educators and seeks to recognize midwives who created innovative educational programs. 

The project aims at delivering to midwifery educators, critical, practical-based education and demonstration of active management of third stage labour (AMTSL) to prevent and manage postpartum hemorrhage (PPH). The project enables educators to transfer skills and knowledge to their students before they go to the clinical area for practice. 

Aloyce Suleiman TZ midwife training 2017

Aloyce Suleiman, clinical instructor from Mkomaindo NTC showing other participants a return demonstration of massaging the uterus

“Postpartum Hemorrhage is one of the leading cause of maternal death in my country. I want to help pregnant women and make a difference in my society that is why I designed this project,” explains Alex. He further adds that, despite some achievements made on maternal health through the years, gaps still remain. Tanzania is still grappling with reducing maternal and neonatal mortality. Yearly, almost 7,900 (MOH: Women and Children First) women die due to complications of pregnancy and child birth and nearly 40,000 (MOH: Women and Children First) babies die during the first 28 days of life. All these deaths can be prevented if only priorities are set on policies and programmes and investment is directed more on resources, essential supplies and quality education for the health cadre. 

Gloriana Ngole midwife TZ training

Gloriana Ngole midiwife educator from Mtwara NTC demostrating to other participants how to examine the placenta after delivery

Postpartum hemorrhage is an unpredictable and rapid cause of maternal death worldwide. Current evidence indicates that active management of the third stage of labor (uterotonic drugs, cord clamping, and controlled cord tension) will significantly reduce the incidence of PPH (WHO, 2001).This requires appropriate equipment and adequate capacity among the caregivers.

“This project is very important as it will be beneficial to all Tanzanians. Midwifery students will acquire competencies, knowledge, skills and attitudes during their course rather than getting this practical based update after finishing the course,” Comments Alex.

Recently, with financial support from ICM, Alex organized and conducted trainings for 24 Midwifery educators in six Nursing and Midwifery Schools in Southern Tanzania.  In total the schools have approximately 360 Nursing and Midwifery students each academic year. “I hope training 24 educators will create a ripple effect as the educators are now well equipped with right knowledge and skills and they will transfer the knowledge and skills on how to save women and their new-born lives through prevention of PPH by AMTSL. Priority was given to Southern region because reports show that Lindi and Mtwara are regions which have many maternal and neonatal deaths compared to other regions in the country. 

Nachingwea midwives 2017

Group photo of Midwifery educators from Nachingwea NTC 

Before the training the participants were provided with pre-test and post-test to determine their level of knowledge received and understanding. The training successfully achieved the following project deliverables:-

  1. Detailed currently updated contents for Active management of Third stage of labour was presented and discussed with participants. Demonstration was done by using MamaNatalie simulator followed by return demonstration for each participant.
  2. Detailed currently updated contents of Management of Post-partum haemorrhage was presented by facilitators and discussed with participants.
  3. Demonstration of managements of PPH by using Mama Natalie simulator was done, including manual removal of placenta and bi-manual compression of uterus followed by return demonstration for each participant.

The 24 midwifery educators came from the following six Nursing and Midwifery Schools:- Ndanda School of Nursing and Midwifery, Nachingwea NTC, Sr. Dr. Thekla Nyangao School of Nursing and Midwifery, Mkomaindo NTC, Mtwara NTC and Newala NTC.

Alex with TZ midwives group photo 2017

Midwifery educators from Ndanda School of Nursing and Midwifery in a group photo after completion of the training

The objectives of the training were to:

  • Deliver practical based content on active management of third stage of labour (AMTSL) and management of PPH to midwife educators
  • Demonstrate the skills on AMTSL and management of PPH to midwife educators by using Mama Nathalie simulator.


“I am humbled and I thank ICM and Johnson & Johnson for selecting me for this award. All I want to see every day is mothers delivering safely and their newborns are healthy. I am proud to win this award and standout globally, I dedicated this award to my country and all young midwives – they should always strive to do their best in saving the lives of pregnant women and their newborns.” Concludes Alex.

About the ICM Education Award

As an encouragement and example for midwifery educators, the award seeks to recognize midwives who created innovative educational programs in original, easily reproducible ways of basic (pre-service) and/or post graduate (in-service) midwifery education. 

Alex James is the 2017 International Confederation of Midwives (ICM) and Johnson and Johnson Education Award Winner from Tanzania and a National Executive Committee Member of Tanzania Midwives Association (TAMA). He is a midwifery educator at Sr. Dr. Thekla Nyangao Nursing and Midwifery School at St. Walburg's Nyangao Hospital in Lindi region.


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