Severe bleeding after childbirth, known as postpartum hemorrhage, is the leading cause of maternal death globally. Though several drugs can treat the life-threatening condition, recent findings show that up to half of all women in low- and middle-income countries who experience postpartum hemorrhage are identified too late or not at all because healthcare staff must rely on visual estimates of blood loss. As a result, life-saving treatment can be delayed or not provided. Jhpiego, with US$2.3 million in support from Unitaid, will now integrate a simple, objective blood loss measurement device – the calibrated drape – into an existing initiative working to make childbirth safer through improved access to recommended postpartum hemorrhage interventions.
The calibrated drape is a piece of plastic sheeting that hangs off the end of the delivery table and collects and measures blood in a clear pouch at its base. This helps birth attendants quickly and accurately identify life-threatening levels of bleeding and connect women in need with treatment.
With additional support from the Gates Foundation, Unitaid and Jhpiego will support integration of the drape into existing health programs in the Democratic Republic of Congo (DRC), Guinea and India, and lead catalytic procurement in Rwanda. These activities are part of the Accelerating Measurable Progress and Leveraging Investments for Postpartum Hemorrhage Impact (AMPLI-PPHI) project, a US$26.7 million investment from Unitaid.
“Postpartum hemorrhage can very quickly become life-threatening. Visually estimating blood loss delays access to critical postpartum hemorrhage treatment for women who need it,” said Dr. Jeffrey Smith, Senior Technical Manager at Unitaid. “Unitaid and Jhpiego aim to help countries answer questions about how best to implement this innovative blood loss measurement device alongside postpartum hemorrhage medicines to support country efforts to reduce maternal deaths through cost-effective interventions.”
In Kenya, where the government has moved ahead with procurement of the drape in Makueni county, the AMPLI-PPHI project is observing promising initial signs that the package of tools the project supports is helping to improve care for women.
“A birth should be a joyous occasion, not a tragedy,” said H.E. Mutula Kilonzo Junior, Governor of Makueni County, Kenya. “It’s heartbreaking that women continue to die from postpartum hemorrhage, a condition that is both preventable and treatable with the right tools and timely care. But with early detection and immediate intervention, we are saving lives. I’m proud to share that since implementing this comprehensive care package, we did not record a single maternal death from postpartum hemorrhage in the public sector in Makueni County in 2023 and 2024.”
The AMPLI-PPHI project aims to improve access to quality health products that prevent, detect and treat postpartum hemorrhage for women in low- and middle-income countries. Project activities in DRC, Guinea, India, Kenya, Nigeria and Zambia are designed to support these countries and the broader regions to scale up lifesaving interventions. In addition to the calibrated drape, the project is accelerating access to heat-stable carbetocin, tranexamic acid and misoprostol – three critical drugs for preventing and treating postpartum hemorrhage.
“With more than 50 years of experience helping countries improve their maternal health services, we are proud to partner with Unitaid,” said Dr. Leslie Mancuso, Jhpiego President and CEO. “This innovative solution ensures timely detection of postpartum hemorrhage and helps health workers act quickly and decisively, saving lives by ensuring rapid response when every second counts.”
In Nigeria and Zambia, AMPLI-PPHI is already integrating the calibrated drape into health programs through SafeBirth Africa, a joint project with the European Union. The additional funding to AMPLI-PPHI will now ensure the calibrated drape is integrated into AMPLI-PPHI programming in the remaining project countries.
Additional quotes
“It is with great joy that we welcome the imminent arrival of calibrated drapes in Guinea. This will improve the quality of postpartum hemorrhage diagnosis and guide appropriate case management through the eMOTIVE approach. We hope to ensure that we have continuous access to the supplier of this medical equipment so that we can purchase it at an affordable price and regularly supply our health facilities,” said Dr. Siré Camara, Head of the National Directorate of Family Health and Nutrition Ministry of Health and Public Hygiene, Guinea.
“Through our supervision in the health zones of Kimpense and Kisantu (Democratic Republic of Congo), we have found that healthcare providers have difficulty objectively quantifying blood loss during childbirth and the postpartum period. This leads to delayed detection of postpartum hemorrhage cases, resulting in late and often difficult management, including delayed referrals to higher-level health facilities, multiple blood transfusions, and sometimes death. These delays compromise the chances of successful treatment… We are therefore eager to begin this initiative, which offers the country an opportunity to reduce maternal mortality related to PPH and thus achieve its SDGs by 2030,” said Dr Chantal Lusikila, Head of the Family Health Division, Ministry of Public Health, Hygiene, and Social Welfare, Democratic Republic of Congo.
About AMPLI-PPHI
The Unitaid-funded Accelerating Measurable Progress and Leveraging Investments for Postpartum Hemorrhage Impact (AMPLI-PPHI) project (2022–2026) is a $26 million initiative that focuses on generating evidence and learning, creating an enabling environment, and preparing the market to enable broad uptake of the three drugs – heat-stable carbetocin, tranexamic acid and misoprostol – in low- and middle-income countries. The Unitaid-Jhpiego program is working in partnership with the International Federation of Gynecology and Obstetrics (FIGO), PATH and country governments in the Democratic Republic of Congo, Guinea, India and Kenya to ensure PPH medications are available at the right time, in the right place, for the right indication, and for the right patient across health systems. With complimentary funding from Safe Birth Africa, a joint Unitaid-UNFPA venture backed by the European Union, AMPLI-PPHI has expanded to Nigeria and Zambia in 2024 to bring greater access to pregnant women and stop bleeding after birth, ultimately reducing maternal morbidity and mortality. The Gates Foundation provided funding to support the integration of the calibrated drapes in DRC, Guinea and India.
About Unitaid
Unitaid is a global health organization that saves lives by making new health products available and affordable for people in low- and middle-income countries. Unitaid works with partners to identify innovative treatments, tests and tools, help tackle the market barriers that are holding them back, and get them to the people who need them most – fast. Since Unitaid was created in 2006, the organization has unlocked access to more than 100 groundbreaking health products to help address the world’s biggest health challenges, including HIV, TB and malaria; women’s and children’s health; and pandemic prevention, preparedness and response. Every year, more than 300 million people benefit from the products Unitaid has helped roll out. Unitaid is hosted by the World Health Organization.
About Jhpiego
Jhpiego is a global health nonprofit with more than 50 years of experience innovating to save the lives of women, men, and families around the world. Originally established in 1973 as the Johns Hopkins Program for International Education in Gynecology and Obstetrics, Jhpiego has since evolved into a multidimensional organization with active programming in over 30 countries. In partnership with national governments, health experts, and local communities, Jhpiego creates and delivers transformative health care solutions that build providers’ skills, strengthen health systems, and ensure equitable access to high-quality, lifesaving care for all—regardless of location.
Unitaid:
Kyle Wilkinson
Communications officer
+41 79 445 17 45
wilkinsonk@unitaid.who.int
Jhpiego:
Naomi Giges Downey
Chief Global Engagement Officer
+1-646-418-6596
Naomi.Downey@jhpiego.org
