By Natalie Ward (Central Queensland University)
During this session, 15 women will die due to childbirth.
This is the reality that I became aware on day two of the World Health Assembly. I started my WHA journey at a session on global surgery for advancing women’s health and maternal health medicines in the face of post-partum haemorrhage (excessive bleeding after childbirth). This event was organised by the Concept Foundation, a not-for-profit organisation working towards ensuring equitable access to quality, low-cost sexual and reproductive health products.
This session focussed on the quality of maternal health medicines, an issue often overlooked in women’s health. To prevent post-partum haemorrhage (PPH), the WHO guidelines recommend the use of oxytocin (used to contract the uterus). Many low- and middle-income countries have easy access to oxytocin, but that the quality is often sub-par. In fact, in 2018 in Nigeria, over 70% of oxytocin samples failed quality testing. Part of this is due to the strict manufacturing and transportation requirements; oxytocin quickly degrades when exposed to heat and must be kept refrigerated. It was fantastic to hear from Concept Foundation panellists who are not only working with countries towards improved manufacturing, transport, labelling and training of individuals working with oxytocin, but also towards alternatives to oxytocin that will suit the needs of low- and middle-income countries. I am eagerly awaiting the results of their study into the effectiveness of Heat-Stable Carbetocin as an alternative to oxytocin. The difference that could be made to maternal health care from a drug that remains stable in heat and humidity is astounding!
I was moved by the images by global health photographer, Paul Joseph Brown, depicting women in Nigeria and India who had experienced PPH and survived. He also captured the devastating images and faces of distraught men and women who had lost their wives, daughters and sisters to PPH. Many of these women died after haemorrhaging in health centres without a blood bank, and their family members were forced to rush to higher-level facilities to arrange blood. Usually their return was too late. These faces are a powerful reminder that PPH is more than shocking statistics, they are real women, babies, partners, parents, siblings and communities. These people are why PPH prevention is so important, and why quality maternal medicines are critical to this mission.
We were left with the message:
“Poor quality is a waste of resources and of life”, and the issue of improving maternal health is one that I have a newfound passion in exploring after such a powerful day at the WHA.