Publication of a Postpartum Hemorrhage Dedicated Open-Access Special Collection in the International Journal of Maternal and Child Health and AIDS (IJMA)

October 17, 2024 - We are pleased to announce the launch of an open-access Special Collection titled: Implementation Research Evidence for Prevention and Treatment of Postpartum Hemorrhage in High Burden Low- and Middle-Income Countries. This Special Collection is sponsored by Merck for Mothers.

Limited progress in meeting the Sustainable Development Goal 3.1 maternal mortality target by 2030 necessitates an urgent call to action. PPH remains the leading cause of maternal mortality globally, predominantly affecting women in low- and middle-income countries (LMICs). It is a preventable emergency condition, but providing adequate and quality care is challenging when health systems face complex barriers that include, but are not limited to, the increasing threat of climate change on sexual and reproductive health and rights (SRHR).

This Special Collection contains eight original research studies assessing the introduction of heat-stable carbetocin (HSC) for PPH prevention and tranexamic acid (TXA) for PPH treatment. These are WHO-recommended medicines which help address cold chain and storage challenges that may compromise the quality of standard practice uterotonics and offer potential solutions to the growing threat of climate change on the SRHR of birthing women.

Broadly, the implementation research featured spans 9 LMICs and assesses the safety, acceptability, feasibility, and appropriate use of the two medicines – highly anticipated results by healthcare providers, decision-makers and donors alike, to help inform introduction and scale effort of both medicines. The Special Collection also features an editorial by IJMA, a commentary by Concept Foundation as the guest editors, and a ‘tale of two medicines’ review article arguing the need for an end-to-end approach to introduce maternal health medicines, using HSC and TXA’s access pathways as case studies.

The research articles provide insightful data collected from over 125,000 women who delivered during the study periods. The research findings collectively demonstrate the appropriate use of HSC and TXA according to the recommendations and the healthcare providers’ favorability of using the medicines.

The papers featured in the Special Collection are as follows:

1. IJMA Editorial: Prevention and Treatment of Postpartum Hemorrhage in High Burden Low- and Middle-Income Countries: Building Cross-National Evidence Through Implementation Research
2. Commentary: Feasibility, Acceptability, and Appropriate Use of Novel and Lesser-Used Medicines for Prevention and Treatment of Postpartum Hemorrhage: Evidence from Implementation Research
3. Narrative Review: A Tale of Two Medicines: The Need for Ownership, End-to-End Planning and Execution for Development and Introduction of Maternal Health Medicines
4. Original Research in Burkina Faso, Ethiopia, Ghana, Sierra Leone, and Uganda Integrating Heat-Stable Carbetocin and Tranexamic Acid for Prevention and Management of Postpartum Hemorrhage in Sub-Saharan Africa: A Five-Country Pilot Implementation Study
5. Original Research in Kenya: Introduction of Heat-Stable Carbetocin for Postpartum Hemorrhage Prevention in Public Sector Hospitals in Kenya: Provider Experience and Policy Insights
6. Original Research in Nigeria: An Implementation Research Study on Uterotonics Use Patterns and Heat-stable Carbetocin Acceptability and Safety for Prevention of Postpartum Hemorrhage in Nigeria
7. Original Research in Uganda: Narrative Review: Postpartum Hemorrhage in Humanitarian Settings: Heat-Stable Carbetocin and Tranexamic Acid Implementation Study in Uganda
8. Original Research in South Sudan: Postpartum Hemorrhage in Humanitarian Settings: Heat-Stable Carbetocin and Tranexamic Acid Implementation Study in South Sudan
9. Original Research in South Sudan and Uganda: Postpartum Hemorrhage in Humanitarian Settings: Implementation Insights from Using Heat-Stable Carbetocin and Tranexamic Acid
10. Original Research in South Sudan and Uganda: Empowering Midwives in Humanitarian Settings: Integrating Heat-Stable Carbetocin and Tranexamic Acid into Postpartum Hemorrhage Training
11. Original Research in India: Introduction of Heat-Stable Carbetocin through a Public-Private Partnership Model: A Retrospective Study to Determine Feasibility and Optimal Use in Public Health Settings in India

This Special Collection presents an impactful opportunity to generate evidence on acceptability and feasibility to introduce HSC and TXA into diverse contexts, as well as shine a spotlight on in-country realities related to cold-chain capability, PPH training gaps, and limitations in health information systems for record capture. We very much encourage you to read this Special Collection in full, as we believe the studies contain valuable research evidence on HSC and TXA that warrants consideration for their introduction as new and lesser-used medicines to improve PPH quality of care, particularly in cold-chain challenged settings.

This Special Collection was supported by funding from Merck, through its Merck for Mothers initiative and is the sole responsibility of the authors. Merck for Mothers is an initiative of Merck & Co., Inc., Rahway, NJ, USA.