Developing Standards for Postpartum Hemorrhage in a Resource-Limited Country

Abstract

Traditionally, standards of care have been developed by a panel of experts and then implemented by a multidisciplinary team. We studied the feasibility of involving health professionals of all grades and policymakers in the establishment of standards for postpartum hemorrhage (PPH) in Malawi. The team established these standards using evidence from Malawi national guidelines and World Health Organization (WHO) manuals. They agreed on 10 objectives and developed the structure, process, and outcome for each objective. The standards addressed different aspects of prevention, diagnosis, and treatment. The involvement of both health professionals and policymakers might promote ownership, sustainability, and allocation of resources for implementation.

Notes

¹Participants agreed the definition of postpartum hemorrhage is loss of >500 mls blood after delivery but noted that loss of less than this could lead to hypovolemic shock in women with preexisting anemia or in women who had suffered blood loss previously, e.g., during labor.