Webinar presentation – Misoprostol for PPH: Innovations for Impact

On December 15, MSH, Gynuity Health Projects and Jhpiego hosted a one-hour webinar to share innovations – interventions, technologies, and distribution approaches – that have the potential to increase access to and use of misoprostol for postpartum hemorrhage (PPH), the leading cause of maternal death. This webinar:

  • Highlighted innovative ways that countries are expanding access to and use of misoprostol for PPH
  • Showed how successful innovations can be scaled up for national impact

PRESENTERS
Esther Azasi
Knowledge Management Specialist & Associate Program Manager, One Million Community Health Workers Campaign-Millennium Promise, Ghana

Holly Anger
Program Associate, Gynuity Health Projects, USA

Gail Webber
Saving Mothers Project, Mara Region, Tanzania and University of Ottawa, Canada

Partamin Manalai
Monitoring, Evaluation and Research Director, Jhpiego, Afghanistan

MODERATOR
Shafia Rashid
Senior Technical Advisor, FCI Program of Management Sciences for Health (MSH)

Listen to the webinar and download the presentation slides here.

Misoprostol for postpartum hemorrhage: Empowering health workers to save lives

Shafia Rashid is a Senior Technical Advisor for the FCI Program of Management Sciences for Health.

In Senegal, approximately 1,800 women lose their lives every year while giving birth. The major cause of these deaths is uncontrolled bleeding after childbirth, or postpartum hemorrhage (PPH). More than half of Senegalese women live in rural areas and have limited access to well-equipped health facilities that can prevent or treat many of these deaths. Many women give birth, attended by matrones or volunteer birth attendants, in maternity huts. Recognized as essential health care providers by their communities, matrones have some formal training and are now registered with the Ministry of Health (MoH).

To effectively prevent or treat PPH, women need access to uterus-contracting drugs, or uterotonics, such as oxytocin or misoprostol. The recommended uterotonic, injectable oxytocin, requires cold storage and technical skill to administer. Misoprostol is a safe and effective alternative where oxytocin isn’t available or feasible; it doesn’t need refrigeration and is easy to use—particularly important features for use in remote, rural areas.

From 2013 to 2014, the Government of Senegal’s Direction of Reproductive Health and Child Survival, in partnership with USAID and Gynuity Health Projects, examined the use of misoprostol (600 mcg oral) or oxytocin (10 UI) via Uniject® for prevention of PPH at the community level. Matrones were trained to assist with deliveries and administer the designated intervention. According to the study, both misoprostol and oxytocin in Uniject® were equally effective and safe in preventing PPH, and matrones  posted at the health huts were capable of administering the medicine they were assigned. Continue reading “Misoprostol for postpartum hemorrhage: Empowering health workers to save lives”

Advocacy success story: Kenya approves misoprostol for PPH

Melissa Wanda Kirowo is advocacy project officer for FCI Program of Management Sciences for Health in Kenya. 

This blog post provides an update to an earlier post.

The Kenya Constitution states that every person has the right to the highest attainable standard of health, including reproductive health. To realize this right, every person must have access to high-quality, life-saving medicines.

Photo credit: Mark Tuschman
Photo credit: Mark Tuschman

Recently, the government achieved great strides toward making this right to health a reality for its citizens. For the first time, the Kenya Essential Medicines List 2016 (KEML) included misoprostol in the oxytocics section, indicating its use for the prevention and treatment of postpartum hemorrhage (PPH), excessive bleeding after childbirth and a leading cause of maternal death. Misoprostol is stable at room temperature, available in pill form, and inexpensive. Because of these advantages and the drug’s wide availability, misoprostol may be a woman’s only chance for surviving PPH in settings with limited infrastructure and a shortage of skilled birth attendants–like many parts of Kenya. Continue reading “Advocacy success story: Kenya approves misoprostol for PPH”

Global Leaders in Maternal Newborn Health: Maria Fernandez Elorriaga (Mexico)

By Kayla McGowan, Project Coordinator, Women and Health Initiative, Harvard T.H. Chan School of Public Health

This article originally appeared on the Maternal Health Task Force blog.

In July 2016, global leaders gathered for the second annual Safe Mothers and Newborns Leadership Workshop (SMNLW) hosted by the Maternal Health Task Force (MHTF) in partnership with the Barcelona Institute for Global Health (ISGlobal) and The Aga Kahn University and sponsored by the Bill & Melinda Gates Foundation. The participants represented 26 countries from five continents.

Maria Fernandez Elorriaga (Mexico)SMNLW participant Maria Fernandez Elorriaga is the principal investigator and technical coordinator of a study investigating the use of the World Health Organization (WHO) Safe Childbirth Checklist to improve the quality of institutional delivery in Mexico. Maria is also co-investigator on two more studies of implementation science in maternal and perinatal care. In addition, Maria has worked as a primary and community care nurse in Spain, as a regional nutrition coordinator in Malawi and as child health and nutrition coordinator in the Sahrawi refugee camps in Tindouf, Algeria. Continue reading “Global Leaders in Maternal Newborn Health: Maria Fernandez Elorriaga (Mexico)”

Misoprostol for postpartum hemorrhage: Closing the gap between knowledge and action

By Shafia Rashid and JoAnn Paradis

Shafia Rashid is Senior Technical Advisor for the FCI Program of Management Sciences for Health and JoAnn Paradis is Strategic Communications Advisor for African Strategies for Health.

In many countries around the world, women give birth at home, often with only a family member or traditional birth attendant by their side. For these women, and for those giving birth in a health facility without reliable electricity, refrigeration, and/or IV therapy, misoprostol may be the best option for preventing and treating postpartum hemorrhage (PPH), one of the leading causes of maternal death globally.

A pregnant girl at Kigali District Hospital, Kigali, Rwanda. (Photo Credit: Todd Shapera)
Photo: Todd Shapera

Despite a global consensus on misoprostol’s safety and effectiveness for PPH prevention, few countries have closed the gap between knowledge and action–taking the steps to ensure that misoprostol is available to women where they are and when they most need it. Only a handful of countries have adopted evidence-based national policies and clinical guidelines that support the use of misoprostol for PPH, and even fewer have scaled these policies into national programs. Continue reading “Misoprostol for postpartum hemorrhage: Closing the gap between knowledge and action”

EML Search: New resource for reproductive and maternal health advocates

Shafia Rashid is Senior Technical Advisor at the FCI Program of Management Sciences for Health.

In June 2013, Imtiaz Kamal–a crusader for midwifery and women’s health–celebrated Pakistan’s official recognition of the essential maternal health medicine, misoprostol, which has proven easy to administer, safe and effective for preventing and treating excessive postpartum bleeding. “Given the high prevalence of home births,” Imtiaz explained, “we need to invest in solutions, such as misoprostol, that save lives now, until we can achieve the long-term goals of strengthening health systems and increasing rates of facility births.” Continue reading “EML Search: New resource for reproductive and maternal health advocates”

Misoprostol For Postpartum Hemorrhage – A Life-Saving Technology for Maternal Health

Shafia Rashid is Senior Technical Advisor for the FCI Program of Management Sciences for Health.

Available since the 1980s, the medicine misoprostol was initially marketed to prevent stomach ulcers. Health professionals eventually discovered that misoprostol also stimulates contractions of the uterus, making it useful for a number of maternal and reproductive health conditions, including postpartum hemorrhage (PPH), induction of labor, treatment of miscarriage, and induced abortion (alone or in combination with mifepristone). Misoprostol is stable at room temperature, available in pill form, and inexpensive. Because of these advantages and misoprostol’s wide availability in many countries, health providers began using misoprostol off-label—in a way not specified on its registration—with differing regimens and routes of administration, and in the absence of evidence-based clinical guidelines. Continue reading “Misoprostol For Postpartum Hemorrhage – A Life-Saving Technology for Maternal Health”