PPH Emergency Care Using a Bundle Approach (PPH EmC) Melody J - PowerPoint PPT Presentation

PPH Emergency Care Using a Bundle Approach (PPH EmC) Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH Community of Practice Annual Meeting July 21 – 23, 2020 PPH COP 2020

The problem: Postpartum hemorrhage remains a leading cause of maternal death. It is treatable. We must, we can save more lives. PPH PPH70 70/30 30 70% REDUCTION ON IN PPH DEATHS AND DISAB ABILITY BY 2030 SDG 3.1 Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

⌑ Clinical: PPH PPH Em EmC ⌑ PPH Emergency Response Respectful Maternity Care ⌑ Non-Clinical: ⌑ Teamwork and Communication ⌑ Network Integration ⌑ Facility Readiness ⌑ Leadership Data, Monitoring and Quality Improvement Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

De Develo lopmen ent Co-creation and initial implementation with international partners WHO Technical Consultation India 04/2018 - 02/2020 on PPH Bundles Kenya 05/2019 - 02/2020 12/2017 Behavioral science research 08/2017 - 04/2020 Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Clin inic ical bundles es ⌑ ⌑ Trigger ⌑ Set of actions Compliance measures Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

De Develo lopmen ent Co-creation and initial implementation with international partners WHO Technical Consultation India 04/2018 - 02/2020 on PPH Bundles Kenya 05/2019 - 02/2020 12/2017 Behavioral science research 08/2017 - 04/2020 Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Behavioral al Science Study Background Objective: To measure quality of care for PPH and explore reasons for gaps in quality Mixed Methods Study Design 3 maternity hospitals and networks of PHCs >900 delivery observations >1000 data points captured per delivery Examined Potential Drivers of Quality wwwnc.cdc.gov/travel/images/map-kenya.png Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Behavioral al Study: Key Findings gs Coverage of many monitoring & preventative care activities is low. Postpartum monitoring is extremely Quality gaps are not fully explained limited. A better understanding of by gaps in knowledge and supplies, provider decision-making can help or by facility busyness. us understand why. Providers at PHCs report limited Challenges with the referral process hands-on experience managing PPH. lead to delays in care. PPH COP 2020 Melody J Eckardt MD MPH, MGH Global Health Innovation Lab

Implic licatio ions for PPH PPH Em EmC Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Develo De lopmen ent Co-creation and initial implementation with international partners WHO Technical Consultation India 04/2018 - 02/2020 on PPH Bundles Kenya 05/2019 - 02/2020 12/2017 Behavioral science research 08/2017 - 04/2020 Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Co Co-cr creatio ion Less ssons Learned ⌑ Advocacy and stakeholder engagement is key ⌑ Committed and respected local champions ⌑ The bundle concept is very well-received are essential ⌑ Ensure flexibility for health system integration ⌑ A focus on teamwork and communication is necessary Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Co Co-cr creatio ion Less ssons Learned ⌑ Network integration is imperative • A communication platform is critical ⌑ Technical assistance and mentorship are necessary • Culture of continued improvement ⌑ Simulation practice increases confidence, organization and efficiency in an emergency • Debrief matters Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

PPH PPH EmC EmC in Ac Action Photo by Thiago Borges Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Par artnerships an and Next Steps ⌑ India (UP) ⌑ Belize ⌑ Kenya (Migori County) ⌑ Select Central and South ⌑ Bangladesh American countries Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020

Ackno nowledgements Thank you to all our partners, collaborators and funders. PPH website: www.savemothers.org For more information on PPH EmC, contact Dr. Melody Eckardt at meckardt@mgh.harvard.edu. PPH COP 2020

Melody J Eckardt MD MPH, MGH Global Health Innovation Lab PPH COP 2020