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Pathfinder Continuum of Care for Addressing PostPartum Hemorrhage PPH

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Dr. Abdelhadi Eltahir, MD, MPH, Senior Advisor for Maternal and ... An Initiative funded by The MacArthur Foundation; Aiming to provide replicable model; ... – PowerPoint PPT presentation

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Title: Pathfinder Continuum of Care for Addressing PostPartum Hemorrhage PPH


1
Pathfinder Continuum of Care for Addressing
Post-Partum Hemorrhage (PPH)
Dr. Abdelhadi Eltahir, MD, MPH, Senior Advisor
for Maternal and Newborn Health, Pathfinder
International
POPPHI Working Group Meeting The George
Washington Universitys Marvin Center 800 21st
St. NW, Washington, DC 20006 April 6, 2006
2
What is Pathfinders Continuum of Care for
Addressing PPH?
  • Pathfinders CC-PPH Project is
  • An Initiative funded by The MacArthur Foundation
  • Aiming to provide replicable model
  • Focusing on new technologies that have
    significant impact in prevention and treatment of
    PPH
  • Initially being implemented in Nigeria and India
    and
  • A collaboration with Local, State and Federal Gvt
    as well as Departments of Health (MOH)

3
The new technologies for the CC-PPH are
  • Active Management of Third Stage of Labor
    (AMTSL)
  • Blood Collection Drape and other effective blood
    loss estimation methods and
  • Non-Pneumatic Anti-Shock Garment (NASG).

4
In Country Scale up and Expansion of the CC-PPH
  • India accounts for 25 of all maternal deaths
    worldwide

5
Nigeria in Country Expansion of the CC-PPH
  • Nigeria second largest number of women dying in
    pregnancy and childbirth

6
Components of Continuum of Care (CC) for PPH
  • Advocacy to gain understanding and support for
    the CC Model with
  • Government officials in departments of health and
    family welfare
  • Community leaders
  • Professional bodies such as FOGSI, SOGON, IMA and
    MWAN
  • AMTSL for preventing PPH
  • Prophylactic use of standard oxytocics
  • Controlled Cord Traction (CCT) and
  • Uterine Massage

7
Components of Continuum of Care (CC) for PPH
(contd)
  • 3. Early detection of hemorrhage Blood
    Collection Drape and other effective blood loss
    estimation methods
  • Early fluid uterotonic treatment of PPH
  • To prevent hypovolemic shock
  • Community organization of transport
  • For rapid referral and safe transfer of obstetric
    emergencies to facilities that can treat PPH
    and shock

8
Components of Continuum of Care for PPH (contd)
6. Anti-Shock Garment (NASG)
  • To resuscitate and stabilize women in shock until
    comprehensive care for PPH and shock is available

9
Components of Continuum of Care for PPH (contd)
7. Treatment of shock with rapid replacement of
blood volume
10
Why focusing on PPH?
11
Continuum of Care National Champions and Opinion
Leaders
12
National Champions Establishment of Maternity
Blood Transfusion Center
Immediate Results
  • Easier access to blood transfusion
  • Significant reduction (about 75) in the waiting
    time from arrival of
  • patient to receiving blood
  • This is a replicable model that should be
    promoted

WWW.Pathfind.org
13
Continuum of Care Availability of Emergency Blood
14
Pathfinder Assists Indian Institutions and
National Champions in Implementing CC-PPH
Rekha Masilamani, Country Representative, India
Dr. M. Muthulaxmi Prof, and HOD
Pathfinder distributes NASG and AMTSL Guidelines
and Protocols in local languages to Teaching
Hospitals and training institutions
15
Pathfinder Training AMTSL in India
Delivery of the baby
16
Pathfinder Training AMTSL in India (contd)
Controlled Cord Traction
17
Pathfinder Training AMTSL in India (contd)
Demonstration of Uterine Massage
18
Pathfinder Training Blood Collection Drape in
India
19
The best outcome of the Continuum of Care India
and Nigeria Project
20
Who is The most important visitor to Hospital?
The patient is the most important visitor in the
Hospital. We are dependent on him. He is the
purpose of our work. He is our business. He is a
human being and not a statistic or a clinical
material, he has feelings, emotions, biases and
wants
Mahatma Gandhi
21
Further Readings and References
  • Geller, S, Adams, MG, Miller, S, A Continuum of
    Care Model for Postpartum Hemorrhage,
    International Journal of Fertility Women's
    Medicine, 52(2-3)97-105, 2008.
  • Miller, S, Hamza, S, Bray E, Gipson R, Nada, K,
    Fathalla, M, Mourad, M. et al. First Aid for
    Obstetrical Hemorrhage The Pilot Study of the
    Non-pneumatic Anti-Shock Garment (NASG) in Egypt.
    BJOG, 113(4) p. 424-9, 2006.
  • Miller, S, Ojengbede A, Turan J, Ojengbede O,
    Butrick E, Hensleigh, P. Anti-Shock Garments for
    Obstetric Hemorrhage. Current Womens Health
    Reviews, 3(1), 3-11, 2007.
  • Pathfinder International, Refusing to Accept
    Maternal Mortality Pathways A Publication of
    Pathfinder International Spring 2009

WWW.Pathfind.org
22
Thank you for listening
Please visit WWW.Pathfind.org
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