MacArthur will invest $11 million to reduce significantly maternal deaths due to postpartum hemorrhage in India and Nigeria, Foundation President Jonathan Fanton announced today at the Women Deliver conference. The centerpiece of this new effort is distribution of the anti-shock garment, a low-cost neoprene suit that helps stabilize women who are bleeding during childbirth.
Pathfinder International will use MacArthur’s grant to introduce a package of low-tech interventions to several hundred health facilities in seven states in India and eight states in Nigeria – two countries that comprise one-third of all maternal deaths globally and are the focus of MacArthur’s international grantmaking. The life-saving package, which requires little training to use, includes –
• the anti-shock garment;
• the uterus-contracting drug, misoprostol, to prevent bleeding;
• a calibrated blood collection drape to diagnose postpartum hemorrhage; and
• transportation to get patients to a health facility for assessment and treatment, as appropriate.
“No other major cause of maternal death can be prevented as easily as postpartum hemorrhage. It accounts for about 30 percent of the more than 500,000 maternal deaths worldwide each year due to childbirth,” Fanton said. “Our hope is that the anti-shock garment will eventually become part of a standard package of care for postpartum hemorrhage in developing countries. Introduction of the garment at scale can help to save hundreds of thousands of lives and help strengthen national health care systems.”
MacArthur has invested nearly $2 million in pilot studies of the anti-shock garment in Egypt, Mexico and Nigeria. Results indicate that the suit has the potential to reduce mortality of women experiencing postpartum hemorrhage by up to 60 percent. If applied globally, the entire intervention package has the potential to prevent more than 130,000 deaths per year – that is 80 percent of all deaths due to postpartum hemorrhage and 25 percent of maternal deaths from all causes.
Made of lightweight neoprene, the anti-shock garment resembles the bottom part of a wetsuit. It was originally developed for use on the battlefield. It can be manufactured inexpensively and is reusable up to 100 times. When the suit's five Velcro closures are tightened around the patient's body, the compression stops blood from flowing to the lower extremities and forces it back to the heart, lungs, and brain to counteract the shock. The results are immediate, buying time to transport the woman to a health facility where she can receive care. The woman can remain in the garment for two to three days, if necessary.
"It is important to address postpartum hemorrhage wherever there is the potential for it to occur, from the community up through the health system," said Dan Pellegrom, President of Pathfinder International. "Prevention and management starts in homes and communities, so it is important to cultivate informed and engaged communities that are aware of the danger signs of hemorrhaging and can transport women to skilled service providers. We are pleased to be working with the governments of India and Nigeria to implement this life-saving initiative."
Introduction of the intervention package will happen in three waves. Pathfinder and its partners will conduct outreach at the national and local levels to educate policymakers and local leaders about its benefits. Then they will provide training to over 900 health care personnel working in 500 sites and 500 traditional birth attendants working in communities. This training will enable health workers to implement the life-saving interventions and to ensure that women who are referred from the community will receive appropriate care once they reach the hospital. Finally, Pathfinder will raise awareness among community members about complications that can be remedied with the help of the anti-shock garment.
MacArthur has long invested in efforts to help increase the chances that women will have safer pregnancies and deliveries – not only a worthy goal in itself, but also an indicator of the availability of services that are needed for women to make informed reproductive choices. Reducing maternal mortality is a priority for MacArthur’s population and reproductive health grantmaking, which focuses its work in India, Mexico, and Nigeria.