Bedside availability of prepared oxytocin and rapid administration after delivery to prevent postpartum hemorrhage: An observational study in Karnataka, India
Posted onSevere adverse maternal outcomes among women in midwife-led versus obstetrician-led care at the onset of labour in the Netherlands: A nationwide cohort study
Posted onA case-control study of correlates of severe acute maternal morbidity in Kabul, Afghanistan
Posted onWhat We Must Do to Get Oxytocin to the Women Who Need It
Posted onLimited access to quality-assured essential medicines is a common problem across the globe. Quality assurance requires strong commitment to quality-assured manufacturers, wholesalers and ongoing quality testing. For relatively inexpensive maternal commodities, such as oxytocin, that are critically important—but not used in high volume—there is little financial incentive for private health sector involvement and more reliance on the public sector to manage procurement. For example, for every pregnancy in Kenya, there are 12 cases of diarrheal disease, and thus treatment with ORS will require more doses, and perhaps lead to greater profitability, than treatment with oxytocin. Thus, quality-assured oxytocin should be a key commodity in national procurements… read more
Misoprostol for Postpartum Hemorrhage: Translating Promise Into Reality
Posted onIn Kenya, where I work as an advocate for women’s health and rights, women continue to die during pregnancy and childbirth at alarming rates. Approximately 25% of these deaths are due to heavy bleeding following childbirth, also known as postpartum hemorrhage or PPH. More than half of women deliver at home; that proportion can be even higher in some counties with limited infrastructure and predominantly rural populations. Even in cases where a woman arrives to a health facility in time, she can still face significant barriers to receive the care she needs… read more
Managing Postpartum Hemorrhage at Home Deliveries in Chitral, Pakistan
Posted onIn Chitral district of Khyber-Pakhtunkhwa (KP) Province, Pakistan, a high rate of home births translates to inadequate or nonexistent treatment for life-threatening obstetric complications, like postpartum hemorrhage (PPH). Customarily, home births are managed by a traditional birth attendant and if a complication like PPH arises, the only care available is to transfer the woman to a higher level facility or have a skilled provider called to the woman’s home to administer oxytocin as treatment. In Chitral, many villages are located far from health centers and access to care is especially difficult due to poor infrastructure and limited transport. Faced with these barriers, women who develop PPH are rarely transferred to a facility, so having treatment options available at home is critical… read more
The relationship between timing of postpartum hemorrhage interventions and adverse outcomes
Posted onLet’s Reward the Use of Maternal Health Supplies
Posted onAs far as maternal health supplies go, it is easy for groups to forget the role of the three key life-saving commodities and therefore fail to prioritize their presence in health facilities 100% of the time. Arguably, services — with their immediate human element — make for better story-telling a lot of the time. And good storytelling is a mainstay of the marketing and publicity that surround award mechanisms. And by comparison, supplies often carry rather sterile connotations of warehouses, supply chains, and transportation… read more
Changing Incentives: Creating a Market for High Quality Oxytocin
Posted onOxytocin is the first-line drug for the prevention and treatment of postpartum hemorrhage (PPH) and is widely available in developing countries. There is a large market for oxytocin and there are many manufacturers of the drug; however there are growing concerns that products are not in good condition when they are injected, either because of poor manufacturing or degradation along the supply chain… read more