Their undertaking to reduce PPH has been bolstered by the results of a community-level intervention targeting PPH in areas with limited resources and in remote areas where PPH complications can be the hardest to manage, especially considering the recommended prophylactic injectable oxytocin requires cold chains and technical skills to administer. In Senegal, PPH is the leading cause of maternal mortality. Searching for better options, Gynuity Health Projects, ChildFund Senegal, USAID’s Community Health Program and the Senegalese government’s Directorate of Reproductive and Child Health studied the use of misoprostol and oxytocin-filled Uniject® to prevent PPH at 28 community health huts in Senegal. Matrones (volunteer birth attendants) were trained to administer either oral misoprostol or Uniject® (oxytocin in a pre-filled, single dose injection) as a prophylaxis. In addition, community members and project staff identified and encouraged pregnant mothers to visit the community health huts.
The project provided either misoprostol or oxytocin filled Uniject® to over 1,300 women, and had only one reported case of PPH. Both misoprostol and oxytocin filled Uniject® were effective.
“Before this study, we saw a lot of women with heavy bleeding, and it was always difficult to arrange transportation for referrals [to health facilities],” said Fatuo Diouf, a matron from the Koulouk Mbada hut. “Now, we do not see any hemorrhage after delivery.”
Results included a reduction in home births from 10% to 1%. Women were interested in delivery services because of the PPH reduction program and because they were promoted by community members and project staff. The project showed that health providers and matrones were able to keep record and stock of the medicines, administer medicines appropriately, and manage side effects from the medicines. An increase in the use and attendance of community health huts was also seen.
This study shows promising options for remote community health stations, allowing the prevention of PPH on a local level without the need for complicated cold-chains or specialized technical skills.
Read more about FCI’s work in this blogpost by Shafia Rashid highlighting the impressive work being done in Senegal.