Nakuru: Nakuru County is collaborating with the University of Nairobi and the World Health Organization (WHO) to conduct training programmes for health workers on ways of addressing Postpartum Haemorrhage (PPH). The initiative aims to provide critical evidence to guide national policy and shape future treatment protocols for the condition.
According to Kenya News Agency, County Director for Health Planning and Administration, Dr. Joy Mugambi, explained that the WHO-backed programme targets to train nurses, midwives, doctors, and clinical officers, focusing on early detection, treatment, and management of the childbirth complication. The programme will also conduct clinical trials and studies to evaluate the safety and effectiveness of a new drug intended to be used as a first-line treatment for postpartum haemorrhage.
Dr. Mugambi highlighted that the clinical trials, dubbed ‘Research to Expand Access to Heat-Stable Carbetocin (HSC) for the Treatment of Postpartum Haemorrhage’ (REACH), will involve Nakuru County Referral and Teaching Hospital, Machakos Level 5 Hospital, and Pumwani Maternity Hospital in Nairobi County. The REACH Trial is a regulatory study aimed at evaluating the safety and efficacy of Heat-Stable Carbetocin (HSC) as a first-line treatment for PPH, a leading cause of maternal mortality globally.
The Director emphasized the importance of reducing maternal deaths through healthcare-based and community interventions. She noted that maternal mortality rates remain a significant challenge in the public health sector, with PPH cited as the main cause of these deaths in Kenya. Continuous refresher training programmes towards PPH prevention and management are crucial for early detection and timely intervention to save lives.
During a meeting at NCRTH, Dr. Mugambi hosted officials from WHO and the University of Nairobi, who are spearheading the study. She affirmed that reducing deaths from childbirth-related bleeding involves strategies such as using Carbetocin drugs and calibrated delivery drapes to accurately measure blood loss. PPH usually occurs within 24 hours of childbirth, but early detection and treatment can be life-saving.
The joint UoN-WHO initiative also focuses on enhancing knowledge and skills of midwives, particularly those in low-resource settings, in PPH prevention and management. It raises awareness about PPH within communities and advocates for policy changes to improve maternal health outcomes. Health workers are encouraged to use the drape technique, which helps in the direct measurement of blood loss, indicating when control measures are necessary.
Dr. Mugambi affirmed Nakuru’s dedication to evidence-informed health policies, using research data to inform decisions that improve patient care and outcomes. In 2023, the Ministry of Health and WHO recommended the use of calibrated drapes to accurately measure blood loss after childbirth. The training initiative encourages the purchase and distribution of drapes to health facilities offering childbirth services.
Professor Zahida Qureshi, the programme’s Principal Investigator, explained that heat-stable Carbetocin presents a promising advancement in PPH management. The new formulation does not require refrigeration, making it practical for use in settings with limited cold storage, particularly in rural areas. WHO has added HSC to its Essential Medicines List, and it is expected to become more widely available soon.
Dr. Testa Dey from WHO emphasized that while HSC is currently approved for PPH prevention, expanding its use for treatment could significantly improve maternal health outcomes. A WHO-backed study involving over 200,000 women showed that immediate and comprehensive treatment significantly improves outcomes. Medical experts advocate for a change in approach to managing PPH, using calibrated drapes and offering all treatments simultaneously.
