Clinical and Community Action to Address Post Partum Hemorrhage

Dr. Abdelhadi Eltahir, Senior Advisor for Maternal and Newborn Health

CORE Group Fall Meeting, Sept 14-15_20101AED Conference Center, Washington, DC

Inspiration, Integration, and Impact

Pathfinder nonprofit organizationMission

. Pathfinder is committed to: ensure that people everywhere have the right and opportunity to live a healthy reproductive life; and to provide women, men, and adolescents with a range of quality health care services

Why addressing PPH is a top priority Issue?

Source: WHO. The World Health Report 2005. Make Every Mother and Child Count. Geneva: World Health Organization, 2005.

1. PPH’s contribution to maternal mortality

2. The urgency of PPH as a killer (2 hrs onset to death)

3. Challenges facing Int’l Community to achieve MDG 5

4. Other socio-economic consequences

Clinical and Community Action to Address PPH Model

Accurate Estimation of Blood Loss

Blood Collection Drape Visual estimationCalibrated Jugs - NigeriaKelly’s Pad - IndiaCloth Matt - BangladeshKanga - Tanzania

4 DelaysRaksha’s H2H approach

1st-Delay in early recognition at Home

3rd-Delay in Accessing the

Health Facility

4th-Delay in receiving care at

the health facility

2nd -Delay in taking decision &

action

India: Maharashtra, Rajathstan, Bihar,

Tamil Nadu

Nigeria: Katsina, Kano, Lagos, Nassarawa, Oyo, Borno, Ebonyi, Cross River

Bangladesh:

Kishoreganj District

Peru:Piura, Lima & Ayacucho States

Where the CC-PPH Model is being Implemented?

Tanzania: Refugee & host community settings in Kigoma State

The Non-Pneumatic Anti-shock Garment (NASG)

The NASG is a temporary first aid device to stabilize a woman who is

in shock until blood and surgery can be provided

NASG shunts blood that accumulates in the lower extremities of the

body to vital organs: the brain, heart and lungs

Please pick your DVD entitled: Clinical and Community Action to Address Post-Partum Hemorrhage

KanoBorno

Katsina

Nigeria Project States

States: Kano, Katsina, Lagos, Oyo, Nassarawa, Cross River, Borno 53 health facilities:

21 PHC, 24 Sec HC8 Tertiary hospitals

Implement model Clinical and Community Action to address PPH:

Government advocacy on NASG and use of misoprostol

2,022 providers trained

32 communities sensitized

Total of 70, 951 deliveries for 2009

339 referral cases

India Pathfinder PPH Projects:A focus on Health System Strengthening

Maharashtra

Rajasthan

Tamil Nadu

Bihar

India Pathfinder PPH Project sites

Example of AMTSL Component

Lima State: Maternal Perinatal InstituteSan Bartolome Hospital Cayetano Heredia Hospital

08 health

centers

128 health

providers

trained

10 meeting

for 147

health

providers

Ayacucho State: Facilities of VilcashuamanCoracora HospitalRegional Hospital of Ayacucho

Piura State: Chulucanas HospitalFacilities of Morropon Chulucanas

Peru PPH Project Sites

Tanzania

Facilities at 3 Refugee Camps

Plus 8 MOH facilities from

hosting community

Refugees total of 90,000

Congolese and Burundians

Health providers trained include

(doctors, nurses, clinical officers

and midwives)

Kigoma State: Nargusu, Mtablia I & II Refugee Camps Plus MOH facilities

Bangladesh

The model is being impemented at all its 3 levels

A community based intervention to enable the women

and their family members to recognize PPH and ensure

referral to an appropriate referral center with emergency

readiness and skilled management.

Kishoreganj District

Acknowledgment

MacArthur Foundation

Pathfinder HQ: Cathy Solter, Susan Collins, Julio Pacca, Ellen Israel,

Kali Drake, Graciela, Mayra Nicolaa & others

Pathfinder country teams:

Nigeria: Murtala Mai, Farouk Jega and team

India: Rema Nanda, Amit Shah and team

Bangladesh: Shabnam Shahnaz and Team

Peru: Miguel Gutierrez and Elizabeth

Tanzania: Jayne Lyons, Mapunda Pasiens, Mustafa and Tanzania

Red Cross Society

Thank You

Let’s make the Lives of every mother and child count

The preceding slides were presented at theCORE Group 2010 Fall Meeting

Washington, DC

To see similar presentations, please visit:www.coregroup.org/resources/meetingreports