How to use heat-stable carbetocin and tranexamic acid for the prevention and treatment of postpartum haemorrhage in low-resource settings

Tran, Nguyen Toan; Schulte-Hillen, Catrin; Bar-Zeev, Sarah; Chidanyika, Agnes; Zeck, Willibald

doi:10.1136/bmjgh-2022-008913

Cited by 1 publication

(2 citation statements)

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“…The disconnect between healthcare providers and these guidelines demands strengthened linkages between civil societies, governments, and healthcare providers. We believe inclusion of HSC and TXA provides an opportunity to engage key national stakeholders on addressing maternal health system challenges 5 Lack of substantive policy and programs (including training) to support the implementation of the guidelines. Some countries faced issues in reflecting new and current evidence because their national guidelines are not regularly updated. The COVID‐19 pandemic made it difficult to keep PPH a key priority with government bodies. Local evidence of HSC use, availability, and pricing became a concern for many countries since the policy updates preceded the regulatory approval of HSC in the countries.…”

Section: Discussionmentioning

confidence: 99%

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Challenges in updating national guidelines and essential medicines lists in Sub‐Saharan African countries to include WHO‐recommended postpartum hemorrhage medicines

Ng'ang'a¹,

Chitimbe²,

Mburu

et al. 2022

Intl J Gynecology & Obste

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Despite the 2017 WHO recommendations on tranexamic acid (TXA) for the treatment of postpartum hemorrhage (PPH), the 2018 uterotonic recommendations (which included heat‐stable carbetocin (HSC) for the prevention of PPH) and their inclusion in the WHO Essential Medicines List (EML), both drugs are still underused or not used at all to manage PPH in many countries with a high burden. HSC is currently being registered in low‐ and middle‐income countries and its policy inclusion is limited and slow. TXA (also heat stable) is available in many countries but is not registered for PPH treatment, which may have contributed to the delay in its inclusion in national guidelines and EMLs. For both drugs, national guidelines will need to be revised and updated for their optimal uptake. We implemented an advocacy initiative to accelerate the necessary normative policy change to ensure access to quality‐assured and heat‐stable medicines for the prevention and treatment of PPH in Sub‐Saharan African countries. Our initiative aimed to raise awareness of the importance of recently recommended medicines for the prevention and treatment of PPH and support the process to update PPH guidelines and EMLs to include these drugs. We highlight the lessons learned during the initiative, including the challenges and opportunities identified in updating PPH policies at the national level.

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Section: Discussionmentioning

confidence: 99%

“…We believe inclusion of HSC and TXA provides an opportunity to engage key national stakeholders on addressing maternal health system challenges. 5 • Lack of substantive policy and programs (including training) to support the implementation of the guidelines.…”

Section: Discussionmentioning

confidence: 99%