Study setting
The ETAPPH trial was conducted at two University of Zimbabwe affiliated hospitals which serve as referral centres; Sally Mugabe Central Hospital (SMCH) and Parirenyatwa Group of Hospitals (Mbuya Nehanda Maternity Hospital-MNMH). On average, 60 elective caesarean sections are done at SMCH per month, while MNMH does 80 elective caesarean section deliveries per month. Care of mothers during delivery was done by senior resident medical officers (SRMO’s), senior hospital officers (SHOs), and registrars or consultants. Anesthetic delivery was conducted by specialist anesthesiologists, registrars, SHOs, nurses and student nurse anesthesiologists (SNA’s) depending on the patient requirements as decided by the team.