In Ghana, nearly half of all mothers give birth without the benefit of a doctor, midwife or even an entry-level nurse. And when complications occur, many mothers literally bleed to death.
Postpartum hemorrhage (PPH) - or excessive bleeding after childbirth - does not get much press in the US because it is rarely fatal. But in settings like sub-Saharan Africa, PPH is the leading cause of maternal death.
Three tiny tablets offer a solution...
VSI's work in Ghana involved leading efforts to bring misoprostol tablets to stem the tide of preventable maternal deaths. In September 2008, the Food and Drugs Board of Ghana took the important policy step of registering misoprostol for obstetric use, including postpartum hemorrhage, one of the leading causes of maternal mortality in the country. Beyond this key policy move, in October 2009, the Ministry of Health approved National Safe Motherhood Protocols which enable the use of misoprostol for management of PPH by community-level providers, bringing access closer to women in the village.
To expand access to PPH prevention, VSI and Ghana Health Service introduced misoprostol at the community level in four diverse districts in Ghana. Tapping into the country's robust midwifery networks, this program trained nurses and midwives to provide the tablets to pregnant women at prenatal visits in the event they could not make it back to a health facility in time to deliver. The results of this pilot project were met with support for national scale-up at the National Dissemination Meeting in March 2012.
VSI's work in Ghana benefited from collaboration with the R3M Program (Reducing Maternal Morbidity and Mortality), a partnership of Population Council, EngenderHealth, Marie Stopies International, Ipas and the Willows Foundation in Ghana.
By the Numbers
Estimated Total Population
Lifetime Risk of Maternal Death
1 woman in 66
Maternal Mortality Ratio
350 per 100,000 live-births
Total Fertility Rate
Births Attended by Skilled Health Provider
Unmet Need for Family Planning
Source: PRB, 2011 and WHO, 2010
Registered Misoprostol Product(s): Misotac®