Clinical and Community Action to Address Post Partum Hemorrhage
Dr. Abdelhadi Eltahir, Senior Advisor for Maternal and Newborn Health
CORE Group Fall Meeting, Sept 14-15_20101AED Conference Center, Washington, DC
Inspiration, Integration, and Impact
Pathfinder nonprofit organizationMission
. Pathfinder is committed to: ensure that people everywhere have the right and opportunity to live a healthy reproductive life; and to provide women, men, and adolescents with a range of quality health care services
Why addressing PPH is a top priority Issue?
Source: WHO. The World Health Report 2005. Make Every Mother and Child Count. Geneva: World Health Organization, 2005.
1. PPH’s contribution to maternal mortality
2. The urgency of PPH as a killer (2 hrs onset to death)
3. Challenges facing Int’l Community to achieve MDG 5
4. Other socio-economic consequences
Accurate Estimation of Blood Loss
Blood Collection Drape Visual estimationCalibrated Jugs - NigeriaKelly’s Pad - IndiaCloth Matt - BangladeshKanga - Tanzania
4 DelaysRaksha’s H2H approach
1st-Delay in early recognition at Home
3rd-Delay in Accessing the
Health Facility
4th-Delay in receiving care at
the health facility
2nd -Delay in taking decision &
action
India: Maharashtra, Rajathstan, Bihar,
Tamil Nadu
Nigeria: Katsina, Kano, Lagos, Nassarawa, Oyo, Borno, Ebonyi, Cross River
Bangladesh:
Kishoreganj District
Peru:Piura, Lima & Ayacucho States
Where the CC-PPH Model is being Implemented?
Tanzania: Refugee & host community settings in Kigoma State
The Non-Pneumatic Anti-shock Garment (NASG)
The NASG is a temporary first aid device to stabilize a woman who is
in shock until blood and surgery can be provided
NASG shunts blood that accumulates in the lower extremities of the
body to vital organs: the brain, heart and lungs
Please pick your DVD entitled: Clinical and Community Action to Address Post-Partum Hemorrhage
KanoBorno
Katsina
Nigeria Project States
States: Kano, Katsina, Lagos, Oyo, Nassarawa, Cross River, Borno 53 health facilities:
21 PHC, 24 Sec HC8 Tertiary hospitals
Implement model Clinical and Community Action to address PPH:
Government advocacy on NASG and use of misoprostol
2,022 providers trained
32 communities sensitized
Total of 70, 951 deliveries for 2009
339 referral cases
India Pathfinder PPH Projects:A focus on Health System Strengthening
Maharashtra
Rajasthan
Tamil Nadu
Bihar
Lima State: Maternal Perinatal InstituteSan Bartolome Hospital Cayetano Heredia Hospital
08 health
centers
128 health
providers
trained
10 meeting
for 147
health
providers
Ayacucho State: Facilities of VilcashuamanCoracora HospitalRegional Hospital of Ayacucho
Piura State: Chulucanas HospitalFacilities of Morropon Chulucanas
Peru PPH Project Sites
Tanzania
Facilities at 3 Refugee Camps
Plus 8 MOH facilities from
hosting community
Refugees total of 90,000
Congolese and Burundians
Health providers trained include
(doctors, nurses, clinical officers
and midwives)
Kigoma State: Nargusu, Mtablia I & II Refugee Camps Plus MOH facilities
Bangladesh
The model is being impemented at all its 3 levels
A community based intervention to enable the women
and their family members to recognize PPH and ensure
referral to an appropriate referral center with emergency
readiness and skilled management.
Kishoreganj District
Acknowledgment
MacArthur Foundation
Pathfinder HQ: Cathy Solter, Susan Collins, Julio Pacca, Ellen Israel,
Kali Drake, Graciela, Mayra Nicolaa & others
Pathfinder country teams:
Nigeria: Murtala Mai, Farouk Jega and team
India: Rema Nanda, Amit Shah and team
Bangladesh: Shabnam Shahnaz and Team
Peru: Miguel Gutierrez and Elizabeth
Tanzania: Jayne Lyons, Mapunda Pasiens, Mustafa and Tanzania
Red Cross Society