Multi country analysis of prevention and management of Post-Partum Haemorrhage (PPH) and Pre-Eclampsia/Eclampsia (PE/E)

To direct attention towards PPH and PE/E, the two major killers of women during pregnancy and birth, a multi country level landscape analysis was conducted by MCHIP in 2011 and 2012 in 40 countries, including countries facing the highest burden of maternal deaths.

The purpose of this analysis was to document progress in national scale-up of PPH and PE/E reduction, focusing on high impact interventions. The analysis used two tools which were completed in country thru consultations with governments and partners: scale up “maps” covering topics from policy to coverage of key interventions and a 44-item questionnaire in English, French & Spanish.

2 years illustrative data from over 30 countries includes: policies to support the Active Management of the Third Stage of Labor (AMTSL) are almost universal for PPH prevention with 90% of countries stating that midwives are authorised to do AMTSL; 39% have piloted Misoprostol for PPH prevention at home births; Magnesium Sulphate is on the essential medicine list of 94% of countries, with midwives authorised to administer it in 84% of countries. However pre-service education or in-service training may not address required competencies.

Overall, policy is ahead of practice and maternal health partners are coming together. Oxytocin/AMTSL and Magnesium Sulphate are authorized, but not always available or used in health facilities. Respondents in Uganda are using the process to identify partners working in each area of maternal health. In Nigeria and Angola, diverse maternal health partners have come together to create a focused agenda to strengthen programs.