Managing Postpartum Hemorrhage at Home Deliveries in Chitral, Pakistan

first_imgPosted on April 15, 2015October 27, 2016By: Meagan Byrne, Program Assistant, Gynuity Health ProjectsClick to share on Facebook (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on LinkedIn (Opens in new window)Click to share on Reddit (Opens in new window)Click to email this to a friend (Opens in new window)Click to print (Opens in new window)In Chitral district of Khyber-Pakhtunkhwa (KP) Province, Pakistan, a high rate of home births translates to inadequate or nonexistent treatment for life-threatening obstetric complications, like postpartum hemorrhage (PPH). According to the 2012-13 Pakistan DHS report, nearly two-thirds of women deliver at home in rural areas of KP province.Customarily, home births are managed by a traditional birth attendant (TBA) and if a complication like PPH arises, the only care available is to transfer the woman to a higher level facility or have a skilled provider called to the woman’s home to administer oxytocin as treatment. In Chitral, many villages are located far from health centers and access to care is especially difficult due to poor infrastructure and limited transport. Faced with these barriers, women who develop PPH are rarely transferred to a facility, so having treatment options available at home is critical.Misoprostol, a prostaglandin analog that reduces blood loss after delivery, is a useful drug in this setting because it requires neither cold storage nor a skilled attendant to administer it. A recent study—implemented in Chitral by Gynuity Health Projects and Aga Khan Health Service, Pakistan—explored the feasibility of providing misoprostol to traditional birth attendants and having them administer it to prevent and treat PPH in home deliveries.In this study, women received misoprostol prophylaxis (a 3-tablet dose) and in the event of PPH, the TBA administered a treatment dose of misoprostol with referral to a higher level of care. Study trainings reiterated the importance of transfer if a woman experiences a delivery complication. Despite prophylaxis, there were women who were diagnosed with PPH and received study treatment. The study confirmed that TBAs are able to administer misoprostol correctly and safely for both prophylaxis and treatment.There has been an increase in the number of facility-based deliveries worldwide; yet for many women, a facility delivery is not an option. Among women in our study who had planned to have a facility delivery, many delivered at home due to road blocks, unavailable transportation, or unavailability of a family member to accompany them to the facility.There will always be women who will not be able to deliver at a facility, despite plan to do so. Among women who deliver at home and experience PPH, many will experience delays or will never be transferred to a health facility. For these women, it is imperative to have a treatment option available at the community level since the average time from onset of PPH to death is only two hours.The following video showcases infrastructure barriers to safe delivery and expresses the thoughts of TBAs and other healthcare providers on access to obstetric services in Chitral and the use of misoprostol to manage PPH. ShareEmailPrint To learn more, read: This post is part of the blog series “Increasing access to maternal and reproductive health supplies: Leveraging lessons learned in preventing maternal mortality,” hosted by the Maternal Health Task Force, Reproductive Health Supplies Coalition/Maternal Health Supplies Caucus, Family Care International and the USAID-Accelovate program at Jhpiego which discusses the importance and methods of reaching women with lifesaving reproductive and maternal health supplies in the context of the proposed new global target of fewer than 70 maternal deaths per 100,000 births by 2030. To contribute a post, contact Katie Millar.Share this:last_img read more

Bringing the best of British to the world

Bringing the best of British to the world

first_imgBBC Worldwide, the commercial arm of the BBC, and VisitBritain, the UK’s national tourism agency, have today announced a new partnership to launch a dedicated content portal, known as BBC Britain, that tells a compelling story of modern Britain. British Airways, one of the world’s leading global premium airlines, has been confirmed as the first company to join the partnership.Sitting within BBC.com, the international version of BBC.co.uk, BBC Britain (www.bbc.com/britain) will combine specially commissioned articles, videos and images with relevant content drawn from across BBC.com’s specialist feature sites, including BBC Culture, BBC Future, BBC Travel, BBC Autos, BBC Capital and BBC Earth.The site’s innovative approach brings to life the UK’s global appeal, taking a balanced and objective look at the story of modern Britain, from London Fashion Week to journeys through the Yorkshire Dales, from Shakespeare to iconic contemporary British businesses, brands and people.Joining forces for the first time, the three partners already have similar missions to bring the best of British to an international audience, via BBC Worldwide showcasing the best UK creative content, VisitBritain’s promotion of the UK’s attractions or British Airways bringing to life British design and customer service.BBC Worldwide will have full editorial control over the site. VisitBritain and British Airways will have all the advertising inventory around the BBC Britain content, which will be populated with joint collateral. There will be future opportunities for other great British brands to come on board as the partnership evolves.Sally Balcombe, CEO VisitBritain, said: “BBC Britain will host a body of content that tells a compelling story of Britain to visitors from across the world, striking a balance between highlighting traditional treasures as well as covering more modern parts of British culture across our nations and regions. We’re pleased to be involved in creating a long term content platform for Britain alongside British Airways, but this is just the start. We’re calling for more British brands to join this partnership as it grows over time.”Tim Davie, CEO BBC Worldwide and Director, Global said: “BBC Worldwide plays a key role in showcasing the UK’s creative industries around the globe and as an ambassador for ‘Brand Britain’ overseas, so I’m delighted to be launching a dedicated place on BBC.com to tell the world about modern Britain.”Sara Dunham, British Airways’ head of marketing, retail and direct, said: “As a proudly British brand with global reach, we’re delighted to be part of an initiative to bring the UK to life for overseas visitors or those wanting to know a little more about the island we call home. We know from experience how interesting people find the UK. It’s a creative, diverse country with great heritage juxtaposed with fantastic modernity. We fly millions of people every year to the UK, and what better way to tempt people to visit than a site that showcases the best of Britain?”BBC.com reaches a monthly average of 85.5 million unique browsers across mobile and desktop, including an average of 8.3 million unique browsers to the non-news feature sections.Source = VisitBritainlast_img read more