Merck for Mothers’ approach to helping to reduce maternal mortality through investments to address the #1 driver of maternal deaths - postpartum hemorrhage

Merck for Mothers ¹ is committed to supporting efforts to reduce maternal mortality globally. We collaborate across sectors — working with NGOs, professional associations, entrepreneurs, UN agencies, research institutions, governments and other companies – to address leading causes of maternal mortality and support countries in their efforts to strengthen health systems.

Our collaborative approach is undertaken with the goal of improving access to quality maternal health care, including access to quality medicines, and has been informed by consensus recommendations from the United Nations Commission on Life Saving Commodities for Women and Children ² .

As the number one driver of maternal mortality, especially in low- and middle-income countries, Merck for Mothers has taken a comprehensive approach to addressing postpartum hemorrhage, or excessive bleeding after childbirth. Our efforts to address postpartum hemorrhage are informed by a health system strengthening approach and identifying possible solutions to challenges through human centered design ^3,4,5,6 . Our aim is to identify, support and advance evidence-based practices for effectively, safely and sustainably introducing new solutions as part of routine standard of care and in accordance with guidelines.

We have invested in new innovations ⁷ and research including clinical trials ^8,9,10 , studies to assess the quality of medicines ¹¹ , research on uterotonic use at country level ¹² and the translation of normative recommendations into policy ¹³ and practice in support of safe and appropriate adoption of solutions to prevent postpartum hemorrhage into health care delivery systems. Our collaborations have focused on:

• Supporting the translation of normative guidelines into policy ^14,15,16,17 and practice at a national level through the development of comprehensive resources, educational tools and job aids ¹⁸
• Training and mentorship for health care workers and procurement managers to support safe and appropriate uterotonic use and improvements in supply chains ¹⁹
• Assistance in exploring innovative financing for new maternal health medicines ²⁰
• Promoting respectful care through amplifying women’s voices ²¹ and supporting their choices through health literacy ²²

Health inequities are often exacerbated by the inability to access quality-assured medicines. Merck for Mothers is investing in country-level implementation research and supporting processes to build capacity of local institutions to introduce innovations ^23,24 and enhance decision making around the use of new medicines, including cost-effectiveness studies, and exploring the challenges and potential solutions to support safe introduction.

At a global level, we prioritize shared learning, supporting global conferences and workshops and disseminating evidence on the experiences of our collaborators - most recently through our support of a supplement in International Journal of Gynecology & Obstetrics on postpartum hemorrhage prevention and management ²⁵ .

These investments in addressing postpartum hemorrhage are a key part of Merck for Mothers broader strategy to improve the quality of maternal health care ²⁶ .