{"id":"https://openalex.org/W7204934063","doi":"https://doi.org/10.35616/jemsm.2026.00248","title":"Cheap, effective, and absent: a policy and guideline analysis of emergency medical services response to postpartum hemorrhage in low- and lower-middle-income countries","display_name":"Cheap, effective, and absent: a policy and guideline analysis of emergency medical services response to postpartum hemorrhage in low- and lower-middle-income countries","publication_year":2026,"publication_date":"2026-09-01","ids":{"openalex":"https://openalex.org/W7204934063","doi":"https://doi.org/10.35616/jemsm.2026.00248"},"language":"en","primary_location":{"id":"doi:10.35616/jemsm.2026.00248","doi":"https://doi.org/10.35616/jemsm.2026.00248","is_oa":true,"landing_page_url":"https://doi.org/10.35616/jemsm.2026.00248","pdf_url":"http://www.jemsmed.org/upload/pdf/jemsm-2026-00248.pdf","source":{"id":"https://openalex.org/S4210219438","display_name":"Journal of EMS Medicine","issn_l":"2671-793X","issn":["2671-793X","2671-7948"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of EMS Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"http://www.jemsmed.org/upload/pdf/jemsm-2026-00248.pdf","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5133856406","display_name":"Elias Van Herwaarde","orcid":"https://orcid.org/0009-0003-6546-5482","observed_orcids":["https://orcid.org/0009-0003-6546-5482"]},"institutions":[{"id":"https://openalex.org/I4210112994","display_name":"University of Bangui","ror":"https://ror.org/020q46z35","country_code":"CF","type":"education","lineage":["https://openalex.org/I4210112994"]}],"countries":["CF"],"is_corresponding":true,"raw_author_name":"Elias van Herwaarde","raw_affiliation_strings":["School of Global Health and Bioethics, P\u00f4le Universitaire Euclide, Bangui, Central African Republic"],"raw_orcid":"https://orcid.org/0009-0003-6546-5482","affiliations":[{"raw_affiliation_string":"School of Global Health and Bioethics, P\u00f4le Universitaire Euclide, Bangui, Central African Republic","institution_ids":["https://openalex.org/I4210112994"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5133856406"],"corresponding_institution_ids":["https://openalex.org/I4210112994"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11389","display_name":"Maternal and fetal healthcare","score":0.8281000256538391,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11389","display_name":"Maternal and fetal healthcare","score":0.8281000256538391,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11467","display_name":"Trauma and Emergency Care Studies","score":0.10859999805688858,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12664","display_name":"Clinical practice guidelines implementation","score":0.01590000092983246,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/postpartum-hemorrhage","display_name":"postpartum hemorrhage","score":0.9940000176429749},{"id":"https://openalex.org/keywords/emergency-medical-services","display_name":"emergency medical services","score":0.9890000224113464},{"id":"https://openalex.org/keywords/prehospital-care","display_name":"prehospital care","score":0.7960000038146973},{"id":"https://openalex.org/keywords/low-and-lower-middle-income-countries","display_name":"low- and lower-middle-income countries","score":0.8539999723434448},{"id":"https://openalex.org/keywords/clinical-guidelines","display_name":"clinical guidelines","score":0.656000018119812},{"id":"https://openalex.org/keywords/policy-analysis","display_name":"policy analysis","score":0.5910000205039978},{"id":"https://openalex.org/keywords/care-bundle","display_name":"care bundle","score":0.5580000281333923},{"id":"https://openalex.org/keywords/non-physician-providers","display_name":"non-physician providers","score":0.8859999775886536},{"id":"https://openalex.org/keywords/ems-training","display_name":"EMS training","score":0.6169999837875366},{"id":"https://openalex.org/keywords/guideline-implementation-barriers","display_name":"barriers to guideline implementation","score":0.5389999747276306},{"id":"https://openalex.org/keywords/obstetric-emergencies","display_name":"obstetric emergencies","score":0.8050000071525574}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7106999754905701},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.632099986076355},{"id":"https://openalex.org/C2780182762","wikidata":"https://www.wikidata.org/wiki/Q1630279","display_name":"Guideline","level":2,"score":0.5767999887466431},{"id":"https://openalex.org/C545288138","wikidata":"https://www.wikidata.org/wiki/Q860447","display_name":"Emergency medical services","level":2,"score":0.4553000032901764},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.37380000948905945},{"id":"https://openalex.org/C3018075012","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Medical services","level":3,"score":0.37049999833106995},{"id":"https://openalex.org/C2986740045","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health services","level":3,"score":0.3463999927043915},{"id":"https://openalex.org/C3018745865","wikidata":"https://www.wikidata.org/wiki/Q749115","display_name":"Postpartum period","level":3,"score":0.3147999942302704},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.28870001435279846},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.27869999408721924},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.275299996137619},{"id":"https://openalex.org/C2779234561","wikidata":"https://www.wikidata.org/wiki/Q11995","display_name":"Pregnancy","level":2,"score":0.25999999046325684},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.2563000023365021},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.2549999952316284}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.35616/jemsm.2026.00248","doi":"https://doi.org/10.35616/jemsm.2026.00248","is_oa":true,"landing_page_url":"https://doi.org/10.35616/jemsm.2026.00248","pdf_url":"http://www.jemsmed.org/upload/pdf/jemsm-2026-00248.pdf","source":{"id":"https://openalex.org/S4210219438","display_name":"Journal of EMS Medicine","issn_l":"2671-793X","issn":["2671-793X","2671-7948"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of EMS Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.35616/jemsm.2026.00248","doi":"https://doi.org/10.35616/jemsm.2026.00248","is_oa":true,"landing_page_url":"https://doi.org/10.35616/jemsm.2026.00248","pdf_url":"http://www.jemsmed.org/upload/pdf/jemsm-2026-00248.pdf","source":{"id":"https://openalex.org/S4210219438","display_name":"Journal of EMS Medicine","issn_l":"2671-793X","issn":["2671-793X","2671-7948"],"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of EMS Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9537000060081482,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204934063.pdf","grobid_xml":"https://content.openalex.org/works/W7204934063.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4404998459","https://openalex.org/W7208778186","https://openalex.org/W3157110058","https://openalex.org/W4405154917","https://openalex.org/W2944394110","https://openalex.org/W7203836230","https://openalex.org/W4311243633","https://openalex.org/W7165041105","https://openalex.org/W2075662474","https://openalex.org/W4403936959"],"abstract_inverted_index":{"Obstetric":[0],"emergencies":[1],"constitute":[2],"approximately":[3],"1%":[4],"of":[5,54,97,142,169,178,187],"emergency":[6],"medical":[7],"services":[8],"(EMS)":[9],"calls":[10],"in":[11,16,31,140,191],"high-income":[12],"countries":[13,20],"but":[14],"15%-25%":[15],"many":[17],"low-and":[18],"lower-middle-income":[19],"(LLMICs).This":[21],"analysis":[22],"examined":[23],"how":[24],"policies":[25],"and":[26,56,67,79,91,116,128,171,184],"guidelines":[27,84],"conceptualize":[28],"EMS":[29,73,118,135,161,189],"roles":[30],"postpartum":[32],"hemorrhage":[33],"(PPH)":[34],"management":[35],"within":[36],"LLMICs.Four":[37],"documents":[38],"were":[39,85,109,164],"purposively":[40],"reviewed:":[41],"the":[42,50,62,68,77,100,148],"World":[43],"Health":[44],"Organization":[45],"(WHO)":[46],"consolidated":[47],"PPH":[48,60,144,181],"guidelines,":[49],"2022":[51],"International":[52],"Federation":[53],"Gynecology":[55],"Obstetrics":[57],"recommendations":[58,115],"on":[59,174],"management,":[61],"WHO":[63],"Prehospital":[64],"Clinical":[65,74],"Protocols,":[66],"Emergency":[69],"Medicine":[70],"Kenya":[71],"Foundation":[72],"Protocols":[75],"2025.Using":[76],"Walt":[78],"Gilson":[80],"Policy":[81],"Triangle":[82],"framework,":[83],"analyzed":[86],"across":[87],"context,":[88],"content,":[89],"actors,":[90],"process.This":[92],"enabled":[93],"a":[94,105],"structured":[95],"comparison":[96],"responsibilities":[98],"at":[99],"prehospital-facility":[101],"interface":[102],"rather":[103],"than":[104,138],"direct":[106],"equivalence":[107],"assessment.Findings":[108],"synthesized":[110],"to":[111,125,131],"assess":[112],"alignment":[113],"between":[114],"LLMIC":[117],"realities,":[119],"while":[120],"recognizing":[121],"regional":[122],"heterogeneity.Gaps":[123],"appear":[124],"reflect":[126],"structural":[127],"policy":[129],"barriers":[130],"translating":[132],"evidence":[133,155],"into":[134],"practice":[136],"more":[137],"limitations":[139],"evidence.Elements":[141],"established":[143],"care":[145,182],"bundles,":[146],"including":[147],"E-MOTIVE":[149],"bundle,":[150,183],"have":[151],"emerging":[152],"or":[153],"indirect":[154],"supporting":[156],"feasibility":[157],"for":[158],"trained":[159],"non-physician":[160,175],"providers.Four":[162],"priorities":[163],"identified:":[165],"EMS-specific":[166],"training,":[167],"reform":[168],"historical":[170],"legislative":[172],"constraints":[173],"practice,":[176],"development":[177],"an":[179],"EMS-validated":[180],"greater":[185],"representation":[186],"LLMIC-based":[188],"experts":[190],"guideline":[192],"development.":[193]},"counts_by_year":[],"updated_date":"2026-10-01T08:54:57.152042","created_date":"2026-09-02T00:00:00"}