First-Aid Device Reduces Postpartum Hemorrhage Deaths in Zambia

The Clinton Health Access Initiative (CHAI) and the Zambia Ministry of Health have published a pivotal study in BMC Health Services Research. This study, conducted in Northern Zambia, represents the first large-scale evaluation of the non-pneumatic anti-shock garment (NASG) globally. The NASG is now widely used across nearly all health facilities in the province to treat postpartum hemorrhage (PPH).

Historical Context

Postpartum hemorrhage has been a significant cause of maternal mortality throughout history. In the 19th and early 20th centuries, maternal deaths due to PPH were common even in high-income countries (HICs). However, advancements in medical technology and healthcare systems have drastically reduced these deaths in HICs. In contrast, low- and middle-income countries (LMICs), particularly in sub-Saharan Africa and South Asia, continue to face high rates of PPH-related deaths due to limited access to timely medical care.

The NASG: A Lifesaving Device

The NASG is a compression device designed to manage severe blood loss following childbirth. It is particularly valuable in remote areas where immediate medical intervention is not available. The device can stabilize women suffering from PPH, buying them crucial time to reach a hospital for further treatment.

Real-Life Impact

Anne, a patient who benefited from the NASG, shared her experience: “I arrived at the clinic bleeding profusely; it was not easy. I thought I was going to die. The nurse attended to me promptly and applied the garment, which saved my life.”

Global PPH Statistics

PPH is a leading cause of maternal mortality worldwide, accounting for over 20% of childbirth-related deaths. While HICs have nearly eradicated these deaths, LMICs still struggle with high mortality rates due to delayed access to emergency care. On average, it takes less than four hours from the onset of hemorrhage for a woman to die, making timely intervention critical.

The Role of NASG in Buying Time

Dr. Yirgu Gebrehiwot, Former President of the Ethiopian Society of Obstetricians & Gynecologists, emphasizes the importance of the NASG: “If a woman starts hemorrhaging after giving birth, she could die within two hours. The NASG can be highly valuable in affording this additional time, especially in rural or resource-limited settings.”

Study Findings

The study covered 143 public health facilities and showed remarkable results. Within 16 months of introducing the NASG, nearly all facilities (99%) maintained their supply, and 88% used the device at least once. Of the 68 recorded applications, 66 were clinically justified. Healthcare professionals overwhelmingly supported the NASG, with 97% endorsing its introduction and 92% confident in its application after training.

Reducing Maternal Mortality

The introduction of the NASG aligns with the World Health Organization’s PPH prevention and care roadmap, which aims to reduce maternal mortality from 2023 to 2030. This study provides a blueprint for other countries to follow, offering valuable insights into effective PPH management.

Summary

• Study Publication: Conducted by CHAI and Zambia Ministry of Health, published in BMC Health Services Research.
• Historical Context: PPH has historically been a major cause of maternal mortality, especially in LMICs.
• NASG Device: A compression device that manages severe blood loss post-childbirth, crucial in remote areas.
• Global PPH Statistics: PPH accounts for over 20% of childbirth-related deaths, predominantly in LMICs.
• Study Findings: 143 facilities in Northern Zambia implemented NASG, with 99% maintaining supply and 88% using it.
• Healthcare Professional Support: 97% endorsed NASG introduction, 92% confident in its application.
• WHO Alignment: Part of a broader strategy to reduce maternal mortality by 2030.

This study underscores the importance of innovative medical devices like the NASG in saving lives and offers a model for other countries to improve maternal health outcomes.