Mayer Shasthya: Reducing Maternal Morbidity and Mortality due to Postpartum Hemorrhage and Eclampsia in a Select Area of Bangladesh

A community nurse leads birth a preparedness session, empowering women with life-saving information, so they can develop a birth plan to identify and prevent postpartum hemorrhage. (Suellen Miller)

A woman receives a safe delivery bag, containing (1) a picture flip booklet with instructions; (2) emergency contact information for health workers and facilities; (3) misoprostol; (4) a blood-loss measuring mat; (5) and a safe delivery kit. (Suellen Miller)

Mayer Shasthya (Mother's Health) was a two year community-based intervention funded by Pathfinder and World Bank to save mother's lives in rural Bangladesh. Based on a model developed in India and Nigeria for the Continuum of Care Project: Addressing Postpartum Hemorrhage in India and Nigeria project, Pathfinder implemented activities to address postpartum hemorrhage in Bangladesh. Pathfinder's approach included increasing awareness of the danger signs of postpartum hemorrhage and the availability of care in project health facilities, improving the capacity of community members and providers to make timely decisions to seek care for postpartum hemorrhage, increasing the ability of the community members and health care providers to identify and reach medical personnel or facilities for postpartum hemorrhage treatment, and improving the capacity of health care providers to provide high-quality, appropriate care to prevent and manage excessive bleeding.

Pathfinder implemented Mayer Shasthya in Karimganj and Tarail Upazilas of Kishoreganj district from April 2010 to March 2011. Pathfinder, along with partner NGOs, conducted the following activities:

• Oriented family members, including the pregnant women, on the importance of measuring the blood loss using the blood drape/mat during and after delivery
• Selected birth attendants; trained them to use drape/mat to identify postpartum hemorrhage
• Conducted group meetings and home visits raising awareness about birth preparedness
• Oriented service providers to share birth preparedness messages during ANC visits
• Established a community support system to facilitate timely referral of women with postpartum hemorrhage to an appropriate facility
• Arranged ambulances for emergency referral to appropriate facilities
• Established linkages between trained/skilled birth attendants to nearest health facilities and from nearest health facilities to tertiary-level facilities
• Organized orientation sessions for providers at various levels of health services to avoid the transportation delay

Progress made by the project:

• 9,943 postpartum hemorrhage bags distributed to pregnant women
• 9,308 women delivered, used the bag, and took Misoprostol
• 2,101 household meetings organized
• 23,304 pregnant women and family members reached
• 184 community group meetings organized and 5,071 community members reached

Success of the project:

• 20 postpartum hemorrhage cases identified and managed in the project areas
• All women used project-supplied Misoprostol, blood collection mat, and delivery kit
• 96 pre-eclampsia identified and followed up