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Maternal health experts discuss efforts to prevent postpartum hemorrhage in Bangladesh, where most births take place at home. (Left to right: Matthews Matthai, Shah Monir Hossain, Deb Armbruster, Gloria Asare, and Rachel Wilson.) Photo: PATH/Megan Miller.

On November 19, staff from the PATH-led Prevention of Postpartum Hemorrhage Initiative (POPPHI) and partners from the field gathered in PATH’s Washington, DC, office to discuss innovative solutions for preventing the leading cause of mothers’ death worldwide. Postpartum hemorrhage (PPH), or excessive bleeding after childbirth, kills an estimated 150,000 women each year. And in developing countries, where most births occur in homes or local clinics, the interventions needed to treat postpartum hemorrhage are often out of reach.

The event, part of PATH’s ongoing Conversations in Global Health series, sought to increase knowledge and understanding of the tools available to combat PPH and to foster discussion about what is needed to continue to make progress on the policy front.

Reaching women most in need

Joined by US government officials and global health advocates, the speakers shared their experiences with efforts to expand the use of active management of the third stage of labor (AMTSL)—a feasible and inexpensive intervention that has been proven to effectively prevent PPH—in developing countries where women are most in need. With expert voices from across the globe, the lively discussion covered the challenges and lessons learned from efforts to improve local services, strengthen health care worker capacity, and make lifesaving drugs and devices available and affordable to the countries that need them most.

POPPHI director Deborah Armbruster provided an overview of the recent progress that has been made to prevent PPH and highlighted possible solutions to future challenges to implementing AMTSL in remote areas across the world.

Dr. Matthews Mathai, a medical officer with the World Health Organization’s Department of Making Pregnancy Safer, addressed the need for improved health systems and increased access to health facilities for pregnant women. Mathai encouraged efforts to improve staff training and retention, as well as assurance of adequate supplies and equipment to prevent PPH.

A national emergency in Ghana

Dr. Gloria Asare, director of the Ghana Health Service’s Family Division, shared her experience with preventing maternal mortality, which Ghana’s health minister declared a national emergency. As a result of the declaration, the country has strengthened its efforts to address PPH by improving providers’ training, the quality of care women receive, and the transportation and storage of medicines necessary to prevent PPH.

Professor Shah Monir Hossain, director general of health services at the Bangladesh Ministry of Health & Family Welfare, shared the challenges and opportunities to PPH prevention in a country where the majority of women give birth at home. He highlighted the need for strategic planning across multiple stakeholders and improved training at the local level.

The speakers noted the successes that they have been able to achieve and the need to continue and enhance such efforts to make the kind of impact they know to be possible to improve maternal health. In Bangladesh, for example, the National Task Force for PPH Prevention has succeeded in unifying and coordinating efforts of multiple groups and stakeholders to prioritize PPH prevention. Additionally, the community-based distribution of misoprostol is successfully being rolled out through a pilot program. Ghana successfully increased its use of AMTSL nine fold over a three-year period.

About Conversations in Global Health

Conversations in Global Health is an ongoing forum for dialogue with PATH experts and partners on select global health issues and challenges. To learn more about the series, please emailadvocacy@path.org.

More information

Posted December 14, 2009.