Professional associations drive policy change for heat-stable carbetocin, tranexamic acid, and misoprostol in six low-income countries to combat postpartum hemorrhage.
Background
Despite clinical guidelines and effective interventions, postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality globally. Variability in diagnostic criteria and access to quality uterotonics, particularly in low- and middle-income countries (LMICs), hinder effective PPH management. The WHO PPH Roadmap emphasizes implementation and advocacy, highlighting the critical need for policy change to ensure access to life-saving drugs like heat-stable carbetocin, especially where cold chain infrastructure for oxytocin is lacking.
Study Design
The Accelerating Measurable Progress and Leveraging Investments for Postpartum Hemorrhage Impact (AMPLI-PPHI) project engaged professional associations across six countries (Democratic Republic of the Congo, Guinea, India, Kenya, Nigeria, and Zambia). The project aimed to generate implementation evidence, foster an enabling environment, and prepare national supply chains for the adoption of three WHO-recommended PPH drugs: heat-stable carbetocin, tranexamic acid, and misoprostol for advance distribution. Researchers utilized the Policy Change Cycle tool and SMART Advocacy approach to influence government action, tracking progress with the SMART Advocacy tool.
Results
Professional associations of obstetrics and gynecology in six diverse countries successfully advocated for the institutionalization of WHO-recommended PPH interventions. This success was achieved by leveraging their trusted relationships with government bodies and employing strategic advocacy approaches. The project facilitated the creation of an enabling environment and prepared national supply chains for the adoption of heat-stable carbetocin, tranexamic acid, and misoprostol for advance distribution.
These advocacy efforts directly contributed to policy changes that support the uptake of crucial PPH prevention and treatment strategies in LMICs.
Key Findings
- Professional associations successfully advocated for WHO-recommended PPH interventions in six LMICs.
- Advocacy efforts focused on heat-stable carbetocin, tranexamic acid, and misoprostol for advance distribution.
- The
Policy Change CycleandSMART Advocacytools were effective in influencing government action. - Associations leveraged trusted government relationships to institutionalize new PPH policies.
- The project prepared national supply chains for the adoption of these critical PPH drugs.
Why It Matters
This study underscores the pivotal role of professional associations in translating global health recommendations into national policy and practice. For clinicians and policymakers, it highlights an effective model for accelerating the uptake of evidence-based interventions in resource-limited settings. The successful advocacy for heat-stable carbetocin, tranexamic acid, and misoprostol means that more women in these countries could gain access to these life-saving drugs, potentially reducing maternal mortality from PPH. This approach provides a blueprint for how to overcome implementation barriers and improve health outcomes through strategic engagement and policy reform, rather than solely focusing on clinical trials.
postpartum-hemorrhage
maternal-health
policy-change
professional-associations
carbetocin
tranexamic-acid