Interpretation
It is anticipated that these algorithms will guide practice in managing
third stage abnormalities, in particular PPH, and ensure the correct
approach is followed and important details are not neglected. Adapting
them to mobile phone technology with a built-in advice system from
higher levels of care should strengthen the use of the algorithms.
Further developments of this process should recognise the need to (a)
incorporate referral systems into the algorithms since maternity care in
LMICs is organised around levels of care5, starting at
community based facilities (Primary level care), referral hospitals
(Secondary level care) and regional/academic hospitals (Tertiary level
care), and (b) consider management of third stage abnormalities
following birth at home or in primary care clinics which was not
considered in the present work. This will depend on the developement of
appropriate content for these settings and the availability of adequate
mobile network coverage and device access to care providers. It is
important that the algorithms are field tested with feedback from users,
to identify problems of interpretation, feasibility and other barriers
to impemenation