MCHIP Strategy for Accelerating Scale Up of Interventions to Prevent and Treat Postpartum Hemorrhage 1 20 Nov 2009 Koki Agarwal Director MCHIP Jhpiego

Our Vision To accelerate the reduction of maternal, newborn and child mortality in the 30 USAID priority countries facing the highest disease burden Our Goal To scale up evidence-based, high impact maternal, newborn and child health (MNCH) interventions to help reduce maternal and child mortality by 25% across 30 priority countries through field-based implementation and global leadership Our Contribution  Introduce and/or improve and expand implementation of high –impact interventions through local implementing partners (Ministries of Health, NGOs, and donor-funded projects);  Global Leadership through advancing implementation research  Program learning;  Technical assistance to share SOTA practices along the MNCH and household-to- hospital continua of care Scope Thematic Skilled Birth Attendance Neonatal Care Zinc Maternal Anemia PPHCBT for Pneumonia Immunization Family Planning PE/E ORT Wat/San Malaria PVO/NGO support, Equity, HSS, P4P (x-cutting) Geographic Year 1 &2: Kenya, Mali, Mozambique, India, So Sudan, Nigeria, DRC, Swaziland, South Africa, Burkina Faso, Ghana. Swaziland, Malawi, Tanzania, Indonesia, Nepal, Bangladesh, Paraguay, Bolivia, Honduras, Guatemala Timeframe MCHIP at a Glance

33 Programs merging into MCHIP  ACCESS  BASICS  ImmunizationBASICS  POPPHI  Child Survival Tech Support +  ACCESS FP  Jhpiego  Save the Children  John Snow, Inc  MACRO  Johns Hopkins (IIP)  PATH  Broad Branch  PSI

Build and Expand on ACCESS and POPPHI Achievements  ACCESS expanded AMTSL to prevent PPH in over 20 countries  Introduced Misoprostol in Nepal and Afghanistan in community settings  Hosted a regional meeting in Africa for 350 individuals from over 22 countries  Provided small grants to 7 NGOs in 6 countries  Developed materials and resources for global dissemination in collaboration with POPPHI  Initiated preservice education for EmONC including PPH in Tanzania, Malawi, Ethiopia and Ghana 4

MCHIP’s Goal for PPH Prevention and Treatment  Ensure that ACCESS and POPPHI countries are supported to achieve greater results  Support at least 20 of HIDN’s priority countries to scale up and provide routine monitoring data on PPH prevention and treatment programs  Continue a global effort to encourage partners to commit to scaling up PPH prevention and treatment  Build on existing knowledge and efforts, using tested tools and approaches 5

MCHIP Approach 6  Global level  Regional level  Country level

Global Level  Form a PPH consortium to continue global level advocacy and consensus building  Work with UN bodies, FIGO, ICM and other global organizations to include indicators to measure progress on PPH  Collaborate with research organizations to determine the simple interventions for PPH including use of oxytocin in Uniject, hydrostatic tamponade, misoprostol treatment  Include PPH as a major focus in global meetings - i.e. Maternal Health Task Force and Women Deliver meetings 7

Regional Level  Ensure prominence of PPH prevention and treatment sessions in regional meetings as well as best practices in scaling them up.  Encourage regional organizations to position and/or maintain PPH as a priority intervention to achieve the MDGs.  Set up a regional collaborative or network to ensure multi-country work on measuring and reporting on PPH  Support regional meetings on PPH

Country Level 9  Use the QoC survey in 8-10 countries to demonstrate gaps in PPH prevention and treatment  Expand the use of SBM R to improve quality of services for AMTSL  In a program learning setting expand community-based distribution of misoprostol to at least four countries in Africa and support scale up in 3 countries in Asia  Use innovative strategies for scale up; e.g. Cambio and training approaches like SAIN  Identify champions that promote PPH prevention at the country and regional level

Kenya Nigeria Mozambique Tanzania Mali DRC Malawi Ghana Ethiopia Madagascar Liberia Afghanistan India Indonesia Nepal Bolivia Guatemala Honduras Paraguay

Thank You 11