Reviewer’s report
Title: 
Knowledge and Skills on Active Management of Third Stage of Labor for
Prevention of Post-partum Haemorrhage Among Health Care Providers in Lake
Zone, Tanzania: A Cross Sectional study
Version: 
0 
Date: 
02 Nov 2020
Reviewer's report:
Thank you for the opportunity to review this manuscript, I have no COI to
disclose. 
The authors present a cross-sectional study assessing the knowledge regarding
the management of third stage labor to prevent subsequent hemorrhage in select
health care providers. The authors highlight areas of weakness among health care
workers which could be the target of future training and courses. The findings
could be interesting to the readers of BMC Women's health. The authors need to
improve the quality of their manuscript, and I suggest a thorough revision of the
language they use. 
Few suggestions:
Please remove "Promoting maternal and child health is a priority goal
worldwide." and "However, uterine atony contributes 70% of PPH." from the
abstract. 
Please define PPH in the abstract. 
"These deaths are preventable if the health care providers (HCPs) are
knowledgeable and skilled of which their information have not well documented
particularly in the lake zone" rephrase. 
"The study revealed that 67.6% HCPs were female" should be "females". Also,
this is not a finding but rather a description of your study sample… so the
authors should not say "revealed".
"Majority of them" change to "the majority of them" 
"Majority of them 171 (50.3%) and 153(45.0%) had adequate knowledge and
skills on AMTSL respectively" rephrase 
"more times likely" change to "more likely" 
"Moreover, HCPs with degree in nursing (AOR: 3.292; 95%CI: 1.187-9.127;
p<0.05) and HCPs with previous BEmONC training (AOR: 2.197; 95%CI
1.235-3.910; p<0.05)." Rephrase 
"In developing countries, maternal mortality is approximately 99% of the
estimated global maternal death, with sub-Sahara alone accounting for roughly
546/100,000 live births followed by southern Asia176/100, 000 live births and
the lowest developing region is Oceania which accounts for 187/100,000 live
births of all deaths [1]." Remove this from the introduction. 
Too detailed.
Please define "AMTSL" at first mention in the text. 
"However, Tanzanian Government" remove "however" 
Methods: please specify how many HCP were present in total, why you decided
to contact 340, and how many of the 340 answered (response rate). 
Why did you consider 5 points answered correctly as adequate knowledge? 
Don't use the term "findings" when describing your study sample. 
What do you mean "scored high'? Isn't this just a 1/0 score? If so, maybe say
"answered correctly" instead. 
"multivariate" change to "multivariable", also please remove "controlled with
other factors"… Multivariable means that other factors were controlled, so no
need to mention this again. 
"More time likely" should be change to "more likely" throughout the text. 
The authors should add a limitation section directly before their conclusion
section. 
The authors could attach the survey as supplementary material.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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Are the methods sufficiently described to allow the study to be repeated?
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Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
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