News and events

News Items:

Representatives of the Malian Association of obstetrics and gynecology (SOMAGO) and the Malian midwifery association (ASFM) sign a joint statement for the prevention of postpartum hemorrhage

Representatives of the Malian Association of obstetrics and gynecology (SOMAGO) and the Malian Midwifery Association (ASFM) developed a joint statement for the prevention of PPH and the rational use of uterotonic drugs during labor. This joint statement was presented on May 11, 2008, at the 11th international day of the midwife, accepted, and then signed by the President of the ASFM, Ms Dicko Fatoumata Maïga, and the Secretary General of the SOMAGO, Dr Youssouf Traoré.

Bamako(Mali), May 11th, 2008: Ms Dicko Fatoumata Maïga (President of the ASFM) and Dr Youssouf Traoré (Executive Secretary of SOMAGO) signing the joint statement for the prevention of postpartum haemorrhage and the rational use of uterotonic drugs. (Photo courtesy of Dr Bruno Carbonne, FIGO)

Skilled birth attendants in the regions of Mopti and Koulikoro, Mali, expand the use of AMTSL using a mixed learning approach

The National Department of Health in Mali is testing the feasibility of using a mixed learning approach to train skilled birth attendants to apply AMTSL. Training activities are decentralized to the district level and providers complete the didactic portion of the course using a self-paced curriculum and then are guided through clinical by the district trainers. Funding for the project was provided by USAID/Mali and technical assistance has been provided by the USAID projects POPPHI, Capacity, ATN, PKC, and SPS.

Representatives of POPPHI/IntraHealth International, Inc., and DPM/SPS with AMTSL point persons in the Djenné District in the Mopti Region of Mali. (Photo courtesy of Dr Daouda Touré, DPM/SPS)

AMTSL in WHO Bulletin

Active management in the third stage of labor survey data on 7 countries has been accepted for publication in the WHO Bulletin

POPPHI initiates and works with partners to expand the use of AMTSL in Mali

Final Evaluation of Matrones Study Underway in Mali. The Capacity Project’s Perle Combary recently assisted in the data analysis and writing of a final evaluation on a study of the role of matrones in the active management of the third stage of labor (AMTSL), a recommended practice to prevent postpartum hemorrhage. The preliminary results of the study—a collaborative effort among the Capacity Project, Prevention of Postpartum Hemorrhage Initiative (POPPHI), Assistance Technique Nationale and Keneya Ciwara Project—suggest that matrones are able to perform AMTSL with the same levels of success and competency as other qualified health-worker cadres. If this initial analysis is confirmed, it will demonstrate the benefits of expanding the role of matrones to improve alignment of maternal health needs with available human resources.Currently, 60% of all births in Mali are attended by matrones; their sanctioned use of AMTSL by the Ministry of Health would assist a very large population across the country.

Democratic Republic of Congo: Integrated maternal and newborn care training package

Newborn in DRC that benefited from integrated essential maternal and newborn care (photo courtesy of Dr Marie Claude Mbuyi, AXxes/USAID)

The USAID projects AXxes/DRC, BASICS, and POPPHI joined together to develop a training package for integrated maternal and newborn care that included newborn survival, clinical decision-making, maternal care during pregnancy that influences newborn survival, prevention of postpartum hemorrhage, active management of the third stage of labor, immediate care of the newborn, monitoring the postpartum woman and newborn during the first six hours after delivery of the placenta, postpartum care for the woman and newborn, newborn resuscitation, care for breastfeeding problems related to the woman, care for the low birthweight baby, and care for minor and major infections of the newborn. Learning activities include interactive classroom sessions, individual learning exercises, demonstrations on anatomic models, and four days of clinical practice. The training package was pre-tested during training of national trainers in July 2008 and received extremely positive feedback from participants about both the training methodology and the content. (Training activities will be rolled out by the Ministry of Health with the financial and technical assistance of the USAID AXxes project.) Follow-up cascade training will be done by those recently trained in Kinshasa and be done on a provincial, district, and ultimately community level. Those trained include AXxes project personnel, Medical School faculty and experts from the DRC Ministry of Health all of whom will branch out and ultimately bring this level of expertise and capacity to hospitals and clinics throughout the country.

Bangladesh: A New POPPHI Project “Scale-Up” Country

We are pleased to announce that Bangladesh has recently become a POPPHI Project “scale-up” country. Activities were launched in Bangladesh in August 2006 at the National Stakeholders’ Meeting on Scale-Up of Postpartum Hemorrhage. Based on recommendations from this meeting, objectives and a number of PPH activities were identified. Bangladesh is moving forward to implement these activities:

  • Provide technical assistance to local organizations and professional associations and support a national assessment of AMTSL services.
  • Work as the secretariat of the national taskforce on prevention of PPH.
  • Review and adapt POPPHI program materials for use and dissemination in Bangladesh.
  • Promote knowledge and use of AMTSL in 3 districts which are located near 3 private hospitals where POPPHI partner EngenderHealth is currently implementing other safe motherhood programs (with potential expansion to at least 9 other Districts in the next year).
  • Provide technical assistance and advocacy to make uterotonic drugs/devices (oxytocin and misoprostol) available at lower levels and include misoprostol in the AMTSL protocol with specific indication.
  • Advocate to include AMTSL and prevention of PPH in the graduate and post graduate curricula of medical schools and colleges in the next year through the PPH Task Force.
  • Set up an AMTSL Center of Excellence.

Upcoming Events:

 

Recent Events:

Global Health Council, May 26-30, 2009, Washington DC

The Global Health Council’s 36th Annual International Conference on Global Health will take place in Washington, DC from May 26–30. This year’s theme is "New Technologies + Proven Strategies = Healthy Communities". For more information please see the conference website http://www.globalhealth.org/conference_2009/.

Postpartum Hemorrhage Working Group meeting, April 6 2009 , PATH

This meeting brought together leading researchers, program managers, clinicians, and pharmaceutical management people to share current data and information, identify research priorities, and assist POPPHI and US Agency for International Development (USAID) to set programmatic priorities.

See Presentations:

See Task Force meeting minutes:

SOGC Round Table Conference, November 3rd, 2008 Ottawa, Ontario

The Society of Obstetricians and Gynaecologists of Canada celebrated the 10th anniversary of its International Women’s Health Program (IWHP). As part of our 10 year anniversary activities, they hosted a Public Awareness Event that focused on the leading direct cause of maternal death in developing countries: Post Partum Hemorrhage. This conference aimed to open discussion about possible low cost interventions to reduce maternal mortality, the use of AMTSL, the implementation of programs at the community level and about current initiatives that are taking place at the international level. Deborah Armbruster was a guest speaker and shared POPPHI's experiences of implementing PPH prevention programs at the community level in developing countries.

WHO Technical Consultation to finalize the recommendation on Postpartum Haemorrhage and Retained Placenta. Geneva, Switzerland November 18-21 2008.

The World Health Organization held a Technical Consultation on the Prevention of PPH in October 2006 and issued evidence-based recommendations. These recommendations followed the recently established standards for developing evidence-based guidelines within WHO and was positively received by other international organizations, nongovernmental organizations and health care workers worldwide. The methodology used in PPH prevention guidelines was followed to issue recommendations on primary PPH and retained placenta management. The interventions focus primarily on excessive bleeding following childbirth due to uterine atony, regardless of whether or not identifiable maternal risk factors exist and AMTSL was practiced. The expert comittee reviewed the evidence, made recommendations, and will finalize them soon.

WHO Second Principal Investigators meeting: Active management of the third stage of labour without controlled cord traction: A randomized non-inferiority controlled trial. Geneva, Switzerland December 3-4 2008.

The active management of the third stage of labour without cord traction trial has as main objective to determine whether the simplified package of oxytocin 10 IU IM/IV is not less effective than the full AMTSL package. The trial aims to recruit 25,000 women delivering vaginally in health facilities in eight countries (Argentia, Eqypt, India, Kenya, South Africa, Philippines, Thailand and Uganda) within a 12 month recruitment period. This meeting reviewed the protocols for the study and held discussions with principal investigators from the various sites.

Past POPPHI Events

POPPHI represented in maternal mortality briefing on Capital Hill, April 16th 2008.

PATH, in collaboration with CARE USA, the White Ribbon Alliance, and Women’s Policy, Inc., co-sponsored a briefing on Capitol Hill on maternal health. The briefing was attended by over 150 participants, including Rep. Lois Capps and supermodel Christy Turlington.

Latin American and Caribbean Regional Conference: Reducing Maternal Mortality through the  Prevention of Postpartum Hemorrhage: Research to Evidence-Based  Practice, March 31- April 3, Managua, Nicaragua

POPPHI, with the support of the USAID LAC Bureau, collaborated with PAHO, URC, LLC, and others, to hold a very successful Latin American and Caribbean (LAC) Regional Conference on evidence-based postpartum hemorrhage prevention strategies and best practices. International and regional experts shared research findings, PPH reduction strategies, and information on early treatment of PPH. There were participants from 12 LAC countries including ministry of health representatives, obstetrician / gynecologists, midwives, along with members and directors of professional associations.

Los Presentaciones: mas se publicarán en breve/ Presentations: more will be posted soon..

 

Cobertura de los medios de la conferencia, más pronto/ Media coverage of the conference, more coming soon..

Estrella de Panamá:http://www.estrelladepanama.com/web/main/ver.php?idnews=22283826  

La Jornada net:http://www.lajornadanet.com/diario/archivo/2008/abril/020408-7.html  

WINNER:http://www.winnernet.org/esp/portal_pub/noticias/noticia.php?noticiaID=4701

Radio La Primerisima:http://www.radiolaprimerisima.com/noticias/general/27009

 

Postpartum Hemorrhage Working Group meeting, March 20, 2008, PATH

This meeting brought together leading researchers, program managers, clinicians, and pharmaceutical management people to share current data and information, identify research priorities, and assist POPPHI and US Agency for International Development (USAID) to set programmatic priorities.

See Presentations:

Task Force meeting minutes coming soon.....


Expert meeting on Labor Induction and Augmentation March 19, 2008, PATH

POPPHI hosted an expert meeting on labor induction and augmentation which brought together WHO, UNICEF, USAID, NIH, Gynuity, academic researchers and experts from the field to review data on labor induction and augmentation, to address the potential improper administration of uterotonic drugs and to explore the current data in order to determine what further efforts should be made and look at next steps. Data was presented from an extensive literature review on the topic of labor induction and augmentation for developed and developing countries by Dr. C. Stanton and A. Lovold, Johns Hopkins Bloomberg School of Public Health. The group of experts concluded that sufficient evidence exists to justify moving ahead in three areas:  1) development of context-specific guidelines for induction and augmentation, citing minimum criteria for staffing and equipment; 2) rigorous investigation of the maternal/perinatal effects of the present use of induction and augmentation in facility and home-based births and 3) ensuring community awareness of the devastating effects of the improper use of these drugs on mothers and babies.

Use of oxytocin and misoprostol for induction or augmentation of labor in low-resource settings: A working paper review: Ann Lovold, BHSc, RM, MP, Cynthia Stanton, PhD, Department of Population, Family and Reproductive Health, The Johns Hopkins Bloomberg School of Public Health

Scaling Up High-Impact FP/MNCH Best Practices: Achieving Millennium Development Goals in Asia and the Near East, September 3-8, 2007, Bangkok, Thailand

This meeting convened in order to disseminate high-impact FP/MNCH best practices for scaling-up in the Asia and Near East region for achieving the Millennium Development Goals. Deb Armbruster lead a panel on AMTSL. For more information on the meetings, please visit the conference website.

Women Deliver: A Global Conference, October 18-20, 2007, London, UK

Women Deliver is a landmark global conference that focused on creating political will to save the lives and improve the health of women, mothers and newborn babies around the world. This year's theme was "Invest in Women - It Pays." This theme captures a simple fact: women's health and rights are critical to the economic, political and social well-being of families, communities and nations. POPPHI organized a panel presentation called Moving Research on Postpartum Hemorrhage into Practice. For more information on the conference, please visit the conference website.

Global Health Council, May 29-June 1, 2007, Washington DC

POPPHI presented findings from the global survey on management of the third stage of labor with the poster Active Management of the Third Stage of Labor: An International Survey of Practices in Seven Countries. For more information on the conference, please visit the conference website.

Postpartum Hemorrhage Working Group meeting, March 26, 2007, PATH

This meeting brought together leading researchers, program managers, clinicians, and pharmaceutical management people to share current data and information, identify research priorities, and assist POPPHI and US Agency for International Development (USAID) to set programmatic priorities.

Presentations:

Oxytocin in Uniject – March 2007 Update: Steve Brooke, Commercialization Advisor, PATH

WHO Recommendations for the Prevention of Postpartum Haemorrhage Results from a WHO Technical Consultation– October 18-20, 2006: Panel Presentation: M.E. Stanton, USAID; R. Derman, University of Missouri/Kansas City; H. Sangvhi, JHPIEGO; D. Armbruster, POPPHI/PATH

Second International Confederation of Midwives Conference: Workshop on the Active Management of the Third Stage, March 11-13, 2007, Mar del Plata, Argentina

PAHO, with support from USAID, sponsored this conference and invited POPPHI to run a workshop on AMTSL as one of the advocacy and skills building workshops within the conference. See the Workshop Report.

Presentation:

Manejo Activo del Tercer Periodo del Parto - Gloria Metcalfe, Consultant, PATH

Launch of Scale-Up Activities in Mali, February 12, 15, and 22, 2007, Bamako, Mopti, and Koulikoro, Mali

Photo in Mali

Lily Kak, USAID, Deborah Armbruster, POPPHI, Susheela Engelbrecht, POPPHI, Gilles Perreault, FIGO at the national launch in Bamako, Mali

Mali training participants

Participants in the national training of trainers in Mali, February 2007

The national meeting to launch prevention of postpartum hemorrhage (PPH) activities was held February 12, 2007 to present current evidence and data on prevention of PPH interventions, present the Mali country situation, and devise an action plan/strategy to scale up these activities with specific roles for meeting participants, partners, and collaborators. This was followed by regional meetings in Mopti and Koulikoro. The success of the launches was largely due to the collaborative efforts and evident motivation/enthusiasm of all partners involved – the Ministry of Health, Rational Pharmaceutical Management Plus (RPM Plus), IntraHealth International, Abt Associates, POPPHI, and Care International. The launch included speakers from RPM Plus, the International Federation of Gynecology and Obstetrics (FIGO), the Society of Obstetricians and Gynecologists of Mali, and the Association of Midwives of Mali, in addition to speakers, or their representatives, that were present at the regional launches.

National dissemination meeting, January 31, 2007, Jakarta, Indonesia

The Indonesian Ministry of Health hosted a national meeting to disseminate the results of the national survey on the management of the third stage of labor and to identify the steps forward.  The meeting was attended by important stakeholders such as USAID, the United Nations Children's Fund (UNICEF), and the United Nations Population Fund (UNFPA), and the findings initiated important discussions on how to improve and scale up the use of active management of the third stage of labor. This effort will receive support from the USAID bilateral Health Systems Program (HSP) and the POPPHI project, among others.

Reducing Maternal Mortality: Evidence-based Interventions and Strategies to Prevent Postpartum Hemorrhage, January 18, 2007, Islamabad, Pakistan

A national meeting on Reducing Maternal Mortality: Evidence-based Interventions and Strategies to Prevent Postpartum Hemorrhage was held in Pakistan, in collaboration with the PAIMAN/USAID bilateral project, on January 18, 2007. This meeting was followed by three provincial workshops held in Peshawar (North West Frontier province), Karachi (Sindh province – and included participants from Balochistan province), and Lahore (Punjab province) between January 20 and February 3, 2007, for 2½ days each.

Data Analysis Workshop, December 11-19, 2006, Baltimore, MD

A data analysis workshop for the national surveys on the management of the third stage of labor was held in Baltimore, Maryland from December 11-19, 2006. Participants included D. Jarquin, LAC/COMIN coordinator and the in-country coordinators from Honduras, El Salvador, Nicaragua, and Guatemala. Indonesia and Benin were also represented. All participants except Benin analyzed their survey data and wrote draft reports on their data.

XVIII FIGO World Congress of Gynecology and Obstetrics, November 5–10, 2006, Kuala Lumpur, Malaysia

This conference was an opportunity to present the data on the Ethiopian and Tanzanian surveys and a forum for extensive dialogue with ob/gyn leaders on their work on PPH prevention and treatment. The approval of a second Joint Statement of FIGO and ICM on Postpartum Hemorrhage Prevention Strategies in Low Resource Settings by their respective Boards of Directors/ Management was announced at this meeting. FIGO’s focus and special initiative on PPH was evident with a significant number of large fora, presentations, posters and materials distributed on PPH. For further information, please visit the Congress website.

WHO Technical Consultation on Postpartum Hemorrhage Prevention Strategies in Low Resource Settings, October 18-20, 2006, Geneva, Switzerland

POPPHI initiated and provided funding for the WHO Technical Consultation on Postpartum Hemorrhage Prevention Strategies in Low Resource Settings. Global experts in obstetrics/gynecology and midwifery joined World Health Organization (WHO) staff to review the evidence on controversial topics on AMTSL such as use of AMTSL by non-skilled attendants, use of misoprostol for PPH prevention, immediate versus delayed cord clamping. The results are likely to recommend the use of AMTSL for all skilled birth attendants (with a slightly expanded definition); use of a uterotonic, including misoprostol and oxytocin, for non-SBAs who are trained to competence to use the uterotonic; and delayed cord clamping.

National Stakholders' Meeting on Scaling Up of Prevention of Postpartum Hemorrhage in Bangladesh, August 31, 2006, Dhaka, Bangladesh

This national meeting was an opportunity to share national and international experiences on prevention and management of PPH and discuss issues, strategies, and activities related to scaling up prevention of PPH.

International Congress, July 12–15, 2006, Goa, India

This conference brought together international policymakers, health care professionals, and other stakeholders to present and discuss new findings in the field of postpartum hemorrhage (PPH) prevention and ways to translate the research into tangible programs and policy changes that will benefit women around the developing world. The conference served as an important forum for the exchange of ideas and experiences as well as forging partnerships. A primary focus of this conference was to share recently completed and very important research (a community-based, randomized placebo-controlled trial) on misoprostol.

MotherNewBorNet, July 9–11, 2006 Delhi, India

The second annual meeting of the MotherNewBorNet brought together representatives from various United States Agency for International Development (USAID)-sponsored programs involved in maternal and child health, including the Prevention of Postpartum Hemorrhage Initiative (POPPHI), Johns Hopkins University/Global Research Activities, Access to clinical and community maternal, neonatal, and women’s health services (ACCESS), Basic Support for Institutionalizing Child Survival (BASICS), and the Extending Service Delivery Project to learn about novel interventions, discuss the obstacles and challenges in the scaling up of maternal and child health, as well as build collaborations and partnerships in different countries. 

Prevention of PPH: Are our efforts working? June 27, 2006, PATH

This meeting was designed to assist USAID in its effort to save maternal lives through PPH prevention activities, including collecting all relevant data on the prevention of PPH, particularly the use of active management of the third stage of labor. This meeting brought together and facilitated discussion on indicators and data collection on AMTSL, among cooperating agencies and child survival grantees, with Cognizant Technical Officers, who are or could be working on the prevention of PPH.

Preventing Mortality from Postpartum Hemorrhage in Africa: Moving From Research to Practice, April 4–7, 2006, Entebbe, Uganda

This conference addressed programming designed to prevent and treat postpartum hemorrhage and gathered health care professionals from all levels, including representatives of ministries of health, leading clinical experts, midwives and nurses, trainers and educators, project managers, and representatives from other United States Agency for International Development (USAID) missions and international organizations. Participants included representatives from 22 African countries (both anglophone and francophone).

Practical Guidance to the Field on the use, storage, and management of uterotonics meeting, March 21, 2006, PATH

This meeting brought together World Health Organization (WHO) (Essential Drug division and Making Pregnancy Safer department), United States Pharmacopeia (USP), International Dispensary Association (IDA), USAID, manufacturers of oxytocin, and program implementers to provide practical guidance to the field on the use, storage, and management of oxytocics, particularly focused on oxytocin as the first line drug for use in postpartum hemorrhage prevention and treatment. A primary issue addressed was the research data indicating that oxytocin can be stored out of refrigeration for up to 3 months at up to 30 degrees Celsius. A synopsis of the meeting will be posted on this website in the near future.

Presentations:

Essential Drugs for Public Health Programs: Ideal Overlap of Regulated Product and Public Health Environments, Steve Brooke, Commercialization Advisor, PATH

Oxytocin: Storage, Labeling and Monograph Issues, Larry Callahan, Scientist, Department of Standards Development, USP

Promoting the use of oxytocin for the prevention of PPH, Hans Hogerzeil, Director, Medicines Policy and Standards, WHO

Simulation study stability Oxytocics, Michiel de Goeje, Technical Pharmacist, Quality Affairs Department, IDA

Postpartum Hemorrhage Working Group meeting, March 20, 2006, PATH

This meeting brought together leading researchers, program managers, clinicians, and pharmaceutical management people to share current data and information, identify research priorities, and assist POPPHI and USAID to set programmatic priorities.

Presentations:

Global Network for Women’s and Children’s Health Research, Pierre Buekens, Dean, School of Public Health and Tropical Medicine, Tulane University, (presentation not available, related article posted)

GIRMMAHP Initiative, Albert Figueras, GIRMMAHP Coordinator, Fundació Institut Català de Farmacologia Barcelona

EUropean Project on obstetric Haemorrhage Reduction: Attitudes, Trial, and  Early warning System, Kathy Herschderfer, Secretary General, International Confederation of Midwives (ICM)

Reducing deaths from postpartum haemorrhage, Justus Hofmeyr, Head, Department of Obstetrics and Gynaecology, Eastern Cape Department of Health, University of the Witwatersrand/Fort Hare