Imagine a situation where a woman has to trek eight kilometres to access an antenatal clinic or hospital for childbirth.
She can bleed to death either before or after giving birth.
This is the situation for some Kenyans in remote areas including Mandera, Garissa and Baringo.
But a lifesaving solution trial conducted in Kenya, Nigeria, South Africa and Tanzania has proved a simple innovation can reduce these deaths.
The study involved more than 210,000 women across 80 hospitals in the four countries.
The study, published in the 'New England Journal of Medicine', investigated ways to detect and reduce the prevalence of postpartum haemorrhages.
But it should be used in a hospital setting.
Postpartum haemorrhage is a serious but rare condition characterised by heavy bleeding that causes a severe drop in blood pressure.
It affects one to five per cent of women who give birth, and those with blood clotting disorders face increased risk.
About 70 per cent of maternal deaths globally occurred in sub-Saharan Africa in 2020, WHO reports.
In Kenya alone, WHO recorded 7,700 maternal deaths as a result of bleeding in 2020.
HOW IT WORKS
A calibrated plastic drape - which is a plastic bag with label that measures blood loss - is part of the intervention to stop the bleeding.
One end of the drape, which looks like a shower curtain, is placed under a woman who has just delivered vaginally; the other end tapers into a collection pouch that hangs down from her bed.
Any blood that is lost after childbirth goes into the bag. Medics can then see from the measurement labels how much blood has been lost, allowing them to act right away. They can administer transfusions as needed.
The blood-collection drape resulted in a 60 per cent reduction in severe blood loss among patients, according to providers who administered the treatments one by one over a longer period of time.
Researchers also said the drape reduced levels of blood loss up to 500 millilitres.
WHO Collaborating Centre co-director Arri Coomarasamy said the drape is complemented by an immediate treatment bundle.
This includes uterine massage and medicines to contract the womb and stop the bleeding.
Another immediate treatment bundle is intravenous fluid administration, an examination and, when needed, escalation to advanced care.
“In the trial, intervention was supported with an implementation strategy consisting of specific training, PPH trolleys or carry cases, engagement of local champions, audits and feedback,” Coomarasamy said.
Coomarasamy said this new approach to treating postpartum haemorrhage could radically improve women’s chances of surviving childbirth globally, helping them get the treatment they need when they need it.
“Time is of the essence when responding to postpartum bleeding, so interventions that eliminate delays in diagnosis or treatment should be game changers for maternal health.”
According to associate director of Maternal and Newborn Child Health at Unicef, Lu Wei Pearson, hardship areas in Kenya are breeding grounds for high mortality and child deaths.
Speaking at the sidelines of the International Maternal Newborn Health Conference in Cape Town, Pearson said the national government needs to have a sit-down with the counties to ensure that these mothers are catered for to prevent deaths.
“It is important for local government to determine how resources are located for essential services within the counties and are deployed to remote areas,” she told the Star.
Pearson, who has spent eight years in Kenya, said every woman has a right to receive antenatal care.
“When a woman leaves a facility it’s important for community health workers to track down the mothers to check how they are doing,” she said.
“Check if they have fevers. They should have regular care. It is important to manage haemorrhage and the national government and counties should handle this.”
“A woman can develop severe conditions. But where is the hospital?” She asked.
(Edited by V. Graham)
