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Pathfinder Continuum of Care for Addressing Post-Partum Hemorrhage (PPH)

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 University’s Marvin Center

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Pathfinder Continuum of Care for Addressing Post-Partum Hemorrhage (PPH)

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  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 University’s Marvin Center 800 21st St. NW, Washington, DC 20006April 6, 2006

  2. What is Pathfinder’s Continuum of Care for Addressing PPH? • Pathfinder’s 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 (cont’d) • 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 (cont’d) 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 (cont’d) 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 (cont’d) Controlled Cord Traction

  17. Pathfinder Training AMTSL in India (cont’d) 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 patientis 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 Women’s 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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