Training frontline staff in India: Postpartum hemorrhage Emergency Care Using a Bundle Approach (PPH EmC)

Postpartum hemorrhage (PPH) is a major maternal killer in India. When the mother dies, it is often due to various delays in seeking appropriate healthcare. Depending on the region of the world, women rarely live close to hospitals that can provide adequate support. Access to specific drugs, an ambulance system or a blood bank can make the difference between life and death. PPH has become a symbol in the fight for global health democratisation where 99% of PPH deaths occur in developing nations. FIGO works with the Massachusetts General Hospital (MGH) and in-country implementation partners to provide PPH technical and training support to select regional and national societies. Building on 10 years of innovative work to reduce PPH-related death and disability, the Massachusetts General Hospital Global Health Innovation Lab (MGH GHI) has collaborated with senior OBGYNs and maternal health champions around the world to co-create a comprehensive initiative to deliver quality PPH emergency care using a bundle approach.

Postpartum hemorrhage Emergency Care Using a Bundle Approach (PPH EmC) is a different way of conceptualizing PPH emergency response that integrates crucial clinical and systems-based interventions for rapid, effective PPH emergency care. Funded by the Bill & Melinda Gates Foundation, the PPH EmC program is an iterative process to strengthen systems of emergency obstetric care delivery. Based on the World Health Organization (WHO) guidelines for PPH management, PPH EmC clinical interventions consist of evidence-based and cost-effective non-surgical interventions that are relatively simple to learn and perform. PPH EmC also highlights health system strengthening strategies to reduce delays and improve adherence to best practices.

Using the Bundle Approach, efforts to combat PPH in the Indian state of Uttar Pradesh are underway. The 6^th of September 2021 marked the completion of the FIGO PPH Emergency Care by bundle approach. The pilot was composed of doctors and nurses by King George’s Medical University (KGMU) based in Uttar Pradesh.

This pilot was supervised by Prof Uma Singh, Dean and HOD, KGMU and other faculty members, supported by the Federation of Obstetrics and Gynaecological Societies of India (FOGSI) and its lead partner Uttar Pradesh Technical University (UPTSU). This is a great achievement towards reducing maternal and newborn mortality in India, where PPH is responsible for 30% of maternal deaths. We want to thank our partners in helping us combat maternal deaths and PPH in India. With them, the fight against maternal mortality continues.