Africa 2010: Contribution to PPH prevention and treatment in Africa

Africa’s Health in 2010 PPH Working Group 6 April, 2009

Acknowledgements

• USAID Bureaus for Global Health, for Africa and for East Africa • Prevention of Postpartum Hemorrhage Initiative (POPPHI) at PATH-DC • Johns Hopkins • Africa’s Health in 2010 at AED • East Central and Southern African Health Community Secretariat (ECSA-HC) • Regional Centre for Quality of Health Care (RCQHC) • Ministries of Health Ethiopia, Tanzania, and Uganda

Africa’s Health in 2010 purpose

•

To provide strategic, analytical, communications and advocacy, and monitoring and evaluation technical assistance to African institutions and networks, and USAID regional and bilateral programs to improve the health status of Africans

Capacity building

• 3 country teams in Ethiopia, Tanzania and Uganda were trained to conduct the survey and analyze the findings.

• African experts from Ethiopia and Benin prepared Ugandan team for survey (south-south collaboration) • ECSA-HC shared findings in regional dissemination fora to advocate for countries to adopt the practice of AMTSL

Partnership

• Collaboration among POPPHI, Africa 2010, ECSA HC and academic institutions • Coordination among ECSA-HC, MOHs and USAID • Co-funding of the surveys in Ethiopia, Tanzania and Uganda via ECSA-HC

National stakeholders dissemination

• Held in all 3 countries • Since then,

Ethiopia

has: – Created a favorable policy envt in support of AMTSL • Preparation of national PPH prevention and treatment guidelines • Inclusion of misoprostol in EDL for PPH • Authorization of HEWs to provide to provide oral misoprostol/ergometrine, practice CCT and manual removal of placenta • AMTSL in preservice training curriculum in 50% of mid-level health professional trg institutions; introduced misoprostol in curriculum in 50% of trg insittutions • Inclusion of misoprostol in low level professionals preservice trg curriculum • In-service and cascade trg in progress

Regional dissemination and advocacy

• 42nd Regional Health Ministers‘ Conference February 2006 • Preventing Mortality from Postpartum Hemorrhage in Africa: Moving from Research to Practice, April 4 - 7, 2006, Entebbe, Uganda (presentation on Ethiopia and Tanzania) • International Congress on PPH in Goa, India • Regional dissemination meeting November 2008 • 48 th Regional Health Ministers’ Conference March 09: advocacy statement for AMTSL adopted

Conclusions

•PPH is most common cause of maternal deaths -Highly preventable •AMTSL is a proven intervention to reduce PPH, hence maternal mortality -Seldom practiced, and when practiced, usually incorrectly, hence the need for capacity building.

•Since AMTSL is effective, it is imperative to promote it as a way to improve EmOC.

Recommendations

• Revise the national STG & formularies • Include AMTSL in pre-service and in-service training curriculum/orientation and provide job aids • Scale up coverage of AMTSL

Thank you