African conference to look at preventing postpartum hemorrhage deaths

A meeting in Uganda in early April will address ways to prevent deaths from postpartum hemorrhage, a leading contributor to Africa's maternal death rate, the highest in the world.

The maternal mortality ratio (MMR) in Africa is at crisis level. African women of reproductive age have the highest death risk from maternal causes in the world, with an average of 830 deaths per 100,000 live births. As it currently stands, the United Nations Millennium Development Goal to reduce maternal mortality in Africa by 75 percent by 2015 is a far-reaching target. One proven effort to close the gap is to aggressively address one of the least-discussed but largest contributors to the high MMR. Severe bleeding after childbirth, also known as postpartum hemorrhage (PPH), is the most fatal complication, accounting for at least one-quarter of maternal deaths worldwide. According to the World Health Organization, PPH occurs in 10-15 women out of 100 giving birth in developing countries, and severe PPH that can lead to death occurs in two out of 100 women. In Africa, PPH contributes to an even higher proportion of maternal mortality. In a region where half of the women deliver without skilled providers, when PPH occurs, a great number of these women die, oftentimes leading to the death or neglect of their newborns as well.

"Maternal mortality is closely related to the accessibility of quality health care. There is an urgent need to address the overwhelming number of deaths due to PPH because most cases are preventable. We can save these women with simple PPH prevention and treatment techniques. Whether the woman gives birth in a facility with a skilled provider present or at home with a family member, we have proven methods to share in Africa that cover the range of birthing situations," comments Dr. Koki Agarwal, Program Director, Access to Clinical and Community Maternal, Neonatal and Women's Health Services (ACCESS).

The ACCESS Program will soon bring together more than 200 Africans from 15 countries to address programming designed to prevent and treat PPH. "Preventing Mortality from Postpartum Hemorrhage in Africa: Moving from Research to Practice" will gather 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 USAID missions and international organizations. This groundbreaking event will take place 4-7 April 2006, in Entebbe, Uganda.

ACCESS is leading the effort worldwide to reduce maternal mortality through a combination of approaches, including: promoting Active Management of the Third Stage of Labor (AMTSL); strengthening the capability of front-line health workers to provide emergency obstetric care and effectively manage PPH when it occurs; and applying an innovative, community-based approach to prevent PPH at homebirths without skilled providers.

The conference is being organized by the ACCESS Program in full partnership with the Regional Centre for Quality of Health Care (RCQHC), the East, Central and Southern Africa Health Secretariat (ECSA) and the Prevention of Postpartum Hemorrhage Initiative (POPPHI), and in collaboration with USAID/Washington and regional offices, the Regional Economic Development Support Office and the West Africa Regional Program.

ACCESS, a five-year global program sponsored by the U.S. Agency for International Development (USAID), aims to improve the health and survival of mothers and their newborns through the use of key maternal and newborn health services. ACCESS works with USAID missions, governments, nongovernmental organizations, local communities and partner agencies in developing countries to achieve sustainable improvements in maternal and newborn health and survival. The program is implemented by JHPIEGO, an affiliate of The Johns Hopkins University, in partnership with Save the Children, the Futures Group, the Academy for Educational Development, the American College of Nurse-Midwives and Interchurch Medical Assistance.

The RCQHC provides leadership in building regional capacity to improve the quality of health care in Africa by promoting better practices through networking, strategic partnerships and education. As the implementing arm of the ECSA Health Community, the ECSA Health Secretariat fosters and promotes regional cooperation in health. POPPHI is a USAID-funded project that seeks to expand AMTSL and other interventions to reduce PPH worldwide.