Three decades ago Patience Cofie decided to dedicate her career to public health—specifically, to the health of women and children in her native Ghana and surrounding countries. Her reasons for the choice were perfectly logical. She had a thirst for knowledge, a good mind for management, and a talent for teaching—traits that would help her establish everything from a national strategy to increase childhood immunization to a community-based health insurance system to help poor women and their children access care.

But personal motivation fueled her passion as well.

“I lost my niece to postpartum hemorrhage,” says Patience, referring to the excessive bleeding during and just after childbirth that is the number one cause of maternal deaths worldwide. “And I thought if there ever is the opportunity, I should try hard to stop it.”

Opportunity arrives

Opportunity arrived in the form of an innovative product called the Uniject™ injection system, combined with a drug called oxytocin.

Oxytocin injection, when administered immediately after child birth, causes the uterus to contract and is effective in reducing the risk of bleeding. It’s usually given to women by health professionals in hospitals. But for women like Patience’s niece who give birth at home or in smaller health clinics, access to both the drug and a trained provider can be intermittent at best.

The Uniject™ injection system may help. It’s a single-use syringe that comes prefilled with a dose of medicine—in this case, oxytocin. It’s easy to use, injection ready, and potentially a lifesaver—if it’s available when and where women need it.

That’s where Patience, who is taking part in next week’s Women Deliver conference on the well-being of women, comes in.

Advocating for transformative innovation

Just because a potentially useful technology exists doesn’t mean it will be adopted and used. Governments and others must be convinced of its safety, effectiveness, and value. Patience’s job is to be an advocate for reducing the risk of postpartum hemorrhage in general, and specifically, for use of oxytocin in Uniject™ packaged with time-temperature indicators. (The indicators measure cumulative exposure to heat and help prevent accidental use of spoiled oxytocin.) The advocacy effort Patience leads in Ghana has four major goals:

• To ensure that oxytocin in Uniject™ is registered within Ghana so that it can be purchased by the government, which provides health care.
• To include it with the government’s essential drug list and safe motherhood protocols as one of the standard treatments used for postpartum hemorrhage in community settings as well as in hospitals.
• To make sure it earns a place in the “cold chain” of proper transportation, refrigeration, and distribution as the product travels from manufacturer to mother.
• To authorize community-based health providers to administer oxytocin in Uniject™ to women in difficult-to-reach communities.

Meeting with the health ministry

To reach those goals, Patience is harnessing the power of partnership. A working group on postpartum hemorrhage is meeting to help focus the government’s attention on reducing maternal deaths. Tactics to reach that goal include using oxytocin in Uniject™, but Patience points out the ultimate aim is much higher, and in many ways more understandable.

“When I started this work,” she says, thinking back on her niece’s death, “I put in all efforts to ensure that we manage to save lives. My passion for the work comes naturally for somebody who is interested in making sure women do not die, particularly from excessive bleeding when we are giving birth.”

More information

• PATH at Women Deliver.

• Our work in preventing postpartum hemorrhage.

• Making childbirth safer: oxytocin in Uniject™.