Feasibility, Acceptability, and Appropriate Use of Novel and Lesser-Used Medicines for Prevention and Treatment of Postpartum Hemorrhage: Evidence from Implementation Research.

Autor:	Rushwan S; Concept Foundation, Avenue de Sécheron, Geneva, Switzerland., Tufa T; Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Swaziland Street, Addis Ababa, Ethiopia., Gülmezoglu M; Concept Foundation, Avenue de Sécheron, Geneva, Switzerland.
Jazyk:	angličtina
Zdroj:	International journal of MCH and AIDS [Int J MCH AIDS] 2024 Sep 23; Vol. 13 (Suppl 1), pp. S4-S8. Date of Electronic Publication: 2024 Sep 23 (Print Publication: 2024).
DOI:	10.25259/IJMA_17_2023
Abstrakt:	Maternal mortality remains one of the primary global health challenges of the 21st century, despite major medical advances in the field. Although solutions are available, inequities determine where mothers die, with the majority of maternal deaths occurring in low- and middle-income countries (LMICs). More than one-third of maternal deaths are related to obstetric hemorrhage and most commonly postpartum hemorrhage (PPH). Effective, quality-assured uterotonics significantly reduce PPH-related morbidity and mortality. Updated World Health Organization (WHO) recommendations on uterotonics used for PPH prevention include the addition of heat-stable carbetocin (HSC) to the suite of prophylactic uterotonic agents as well as the use of tranexamic acid (TXA) for PPH treatment. Both medicines are promising interventions in obstetric care. However, the introduction of these medicines faces numerous challenges to end-user access, such as decentralized procurement, time-consuming policy updates, market access barriers, lack of demand for quality-assured products, and inadequate systematic training and information provision, impeding access in many LMICs. Assessing the feasibility and acceptability of implementing these medicines in different resource settings can help bridge the gap between research and development to policy and practice, in an effort to reduce the significant health inequities facing women accessing the public health sector for quality care during labor and delivery. In this Special Collection, we explore the findings from mixed-methods implementation research studies in nine LMICs which support the acceptability and feasibility of HSC and TXA administration by healthcare providers, generating evidence to help inform the introduction and scale-up of these new and lesser-utilized PPH medicines. Competing Interests: Concept Foundation assists the innovator of heat-stable carbetocin in registering the medicine in low- and middle-income countries. Concept Foundation works with one tranexamic acid innovator to develop products that are easier to use at peripheral levels of healthcare. (© 2024 The Authors. Published by Global Health and Education Projects, Inc., USA.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu