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URC/CHS News Archives | Contact us | Home URC/CHS NewsUSAID's FrontLines Features PISAF's Success in Reducing Post-partum Hemorrhage USAID's Frontlines and La Nation, Benin’s national newspaper, featured stories about how the USAID-funded Integrated Family Health Program (PISAF) is reducing post-partum hemorrhage (PPH)—the country’s primary cause of maternal mortality—in two heavily populated provinces. "Improved Obstetric Care in Benin is Saving Women's Lives" published in the November issue of FrontLines was written by Dr. André Yebadokpo and Suzanne Gold of URC.
The articles describe how URC, in partnership with the government of Benin, is ensuring that Active Management of Third Stage Labor (AMTSL) is routinely applied during deliveries. AMTSL has been proven to reduce the incidence of life-threatening hemorrhages. The stories feature the perspectives of a new mother and her relieved and grateful husband (see photo, left, and story below). Benin suffers high maternal mortality burden
Benin ranks 163 out of 177 for suffering the highest rates of maternal mortality. Most maternal deaths—more than a third—are due to PPH, excessive uterine bleeding that sometimes occurs after childbirth. URC is working with the government of Benin to reverse alarming trend Improvement collaborative helps put policy into practice PISAF is implementing an improvement collaborative, a way to improve the quality of health care which focuses on strengthening the health care system so that policies can be translated into effective practice.
In collaboratives, practitioners from different levels of the health system work together to determine ways to rapidly improve quality in a specific health care area. Teams develop indicators and a proposed set of practices, test the new practices, and apply successful changes on a larger scale. PISAF produces rapid progress in helping health facilities apply AMSTL PISAF launched a collaborative in April 2008 to improve maternal and newborn care, with a focus on implementing AMTSL as a routine practice in maternal care services. The collaborative is also working to improve essential newborn care and infection prevention. The initial phase of the collaborative included 17 health facility sites: 1 district hospital, 4 zonal hospitals, and 12 health centers. The facilities are implementing changes to ensure that they provide the three components of AMTSL: 1) administering hormone oxytocin, which helps the uterus contract immediately after the birth of the baby; 2) careful traction of the umbilical cord, and 3) uterine massage. All of these practices help the uterus contract and prevent the uterine bleeding that can lead to death if left unchecked.
PISAF has made rapid progress in supporting health facilities to routinely and fully apply AMTSL. As performance of all three elements rose from 73% to 98% in less than a year (May 2008 to March 2009), post-partum hemorrhage dropped significantly from 1.5% to 0.7%, a 53% decrease (see chart at left). Collaborative expands as a result of success Due to the success of the collaborative in reducing PPH in its demonstration phase, PISAF expanded it to 22 new sites in June 2009. Efforts are underway to add interventions to prevent eclampsia—a significant cause of maternal mortality—and to integrate prevention of mother-to-child transmission of HIV (PMTCT) at all 39 sites. Download articles on PISAF’s work in Benin For more information on PISAF’s initiative to reduce maternal mortality, please contact Suzanne Gold at sgold@urc-chs.com.
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