Helping Mothers Survive Bleeding After Birth (HMS – BAB)

A joint effort evaluating the impact of the Helping Mothers Survive Bleeding After Birth (HMS – BAB) low dose, high frequency training programme for the management of postpartum haemorrhage.

A cluster randomized two-arm facility-based trial in Uganda.

Principal Investigator:



Background: Haemorrhage continues to be a major cause of death of mothers giving birth in sub-Saharan Africa, Uganda inclusive.  Many effective interventions are available to prevent and treat post-partum haemorrhage. However, training and skills of health providers attending births remain insufficient.

Study aim: To assess the impact of a 1-day competency-based training “Helping Mothers Survive: Bleeding after Birth” on morbidity and mortality due to post-partum haemorrhage.


Data collectors at Mbale Hospital

Method: This is a cluster randomized two-arm trial before and after facility-based intervention with control group to assess changes in severe morbidity (near-miss) and mortality due to post-partum haemorrhage. The study will include 16 clusters (health districts) which will be randomized to either receiving or not receiving the training. Main outcome measures are proportion of haemorrhage near-miss of total near-miss cases.  To measure haemorrhage-near miss we will use an adapted version of the WHO near-miss classification. Secondary outcomes are skills of health provider and management capacities to deal with post-partum haemorrhage.

Impact: The study aims to inform policy makers on the effect of the 1-day competency training on improvement of health worker skills and reduction of maternal mortality and morbidity due to post-partum haemorrhage and also inform scaling up of this training module in Uganda and other low-resource settings.


Dr Susan with some data collectors at the Central training

Collaborating Partners: International Federation of Gynaecology and Obstetrics (FIGO), International Confederation of Midwives (ICM), Association of Obstetricians and Gynaecologists of Uganda (AOGU), Uganda Nurses and Midwives Union (UNMU) & Uganda Private Midwives Association (UPMA)

Compiled by: Dr Susan Atuhairwe, Study Co-PI AOGU