Our findings may have direct implications for clinicians in resource poor settings. We demonstrated that women’s characteristics, aspects of pregnancy and delivery; PPH management; and organizational characteristics of hospitals are risk factors for PPH maternal mortality in SSA. We suggest that severe antepartum anemia should be diagnosed more accurately and treated before delivery, while effort should be put on improving the capacity of the blood banks and making blood quickly accessible when needed. Early detection of PPH and timely decision-making for transfusion are critical. It is also important to improve the identification of women who need to be transferred to another facility and transportation system. Finally, our findings suggest that training in emergency obstetric care of GPs is probably insufficient. If that training may respond to the shortage of obstetricians, whose training is time and money consuming; on the other hand it prevents the same quality care. A better supervision and extensive training are essential keys to reduce gaps in knowledge and to prevent PPH maternal death.