BACKGROUND:
Postpartum haemorrhage (PPH) is the leading cause of maternal mortality globally and in Pakistan. Despite the existence of WHO guidelines, PPH continues to result in preventable deaths due to delayed detection and inconsistent implementation of evidence-based practices. The E-MOTIVE bundle offers an integrated care approach, for timely PPH management and is being adapted for low-resource settings like Pakistan.

OBJECTIVES:
This study aimed to explore healthcare providers’ perceptions regarding current practices in PPH detection and management, and assess enablers, barriers, and recommendations for implementing the E-MOTIVE bundle in public healthcare settings in Pakistan.

METHODS:
An exploratory, descriptive qualitative study was conducted using semi-structured, in-depth interviews with 15 healthcare providers and three hospital administrators from three public healthcare facilities in Pakistan. Data were analyzed using thematic analysis. Ethics approval was obtained from institutional IRB committee.

RESULTS:
Three major themes emerged: (1) current practices in detection and management of PPH; (2) facilitators such as teamwork, clinical guidelines, leadership, and availability of supplies; and (3) barriers including cultural beliefs, resource constraints, administrative inefficiencies, and lack of standardized training. Midwives and nurses emphasized the value of early recognition, teamwork, and guideline-based responses but highlighted critical needs such as clear protocols and hands-on training

CONCLUSIONS:
The findings underscore the complex interplay of clinical, cultural, and systemic factors that shape PPH care in Pakistan. Implementing the E-MOTIVE bundle in low-resource settings requires not only clinical training but also systemic support, community sensitization, and institutional accountability. Strengthening midwifery leadership, ongoing capacity building, and equitable resource allocation are essential to improving maternal outcomes and sustaining practice improvements.

KEY MESSAGE:
Implementing the E-MOTIVE bundle enhances midwives’ ability to detect and manage PPH through standardized protocols, teamwork, and real-time decision-making. For sustainable maternal care improvements, midwifery practice must be supported with ongoing training, leadership roles, and access to essential supplies and referral systems in rural healthcare settings. Poster session 2 (Group A)