Improve Diagnosis and Treatment of Postpartum Hemorrhaging

Prevent maternal deaths

Tanzania has a relatively high maternal mortality ratio of 410 per 100,000 live births. Severe postpartum hemorrhage (PPH) is a major cause of maternal deaths, but in most cases, it is preventable. Most pregnant women that develop PPH, have no known risk factors. Therefore, preventive measures (giving uterotonics, delayed cord clamping, and controlled cord traction) during the 3rd stage of labor are or should be offered to all pregnant women.

In Karimu's current service area we observe that these cases are present, but rare. However, that raises the concern that medical staff may not recall how to diagnose or treat the issue in an emergency. In addition, we anticipate cases rising with the opening of the Dareda Kati Health Center which can serve more risky pregnancies. 

Our goal with this intervention is to ensure that the medical staff know how to assess, diagnose, and treat postpartum hemorrhages.

The government agreed to train two nurses from the Dareda Kati Health Center in PPH management at their cost. Those nurses are training all Dareda Kati Health Center and dispensary staff who are care providers directly to patients. Karimu is paying for the cost of the nurses providing the training to the staff and dispensaries.

In addition, Dareda Kati Health Center staff will meet weekly to review challenging cases including PPH to discuss if it was handled correctly and how care might be improved if needed. Quarterly reviews of cases with the dispensaries will also assess whether PPH cases were handled appropriately and assure continued improvement of diagnosis and treatment. We will track that all health center and dispensary staff have been trained and that the quarterly reviews are done regularly and effectively over the course of the next year. 

Benefits:

• Improve postpartum care

• Prevent maternal deaths

Cost: 

• Karimu cost: $2000

• Community cost and/or contribution: $700