Earlier this year, our Senior Engagement Manager, Toluwanimi Adewole, and the CCSI - Centre for Communication and Social Impact visited Kano to document “The EMOTIVE Effect Impact Stories.” The visit aimed to understand the transformative work led by Prof. Hadiza Shehu Galadanci, the pioneer of the EMOTIVE intervention in Nigeria. We also gained valuable insights from service providers and beneficiaries who were part of the EMOTIVE trial and leveraged the documentary to tell their stories.
With postpartum hemorrhage (PPH) being the leading cause of maternal mortality worldwide, accounting for over 25% of all maternal deaths globally, the collaboration between CCSI - Centre for Communication and Social Impact and ACE Strategy and Consults Ltd. could not have been more timely in documenting The EMOTIVE Effect Impact Stories. This initiative was designed to spotlight the intervention and its impact, as it has proven to significantly reduce deaths caused by PPH (bleeding out after childbirth).
The lead researcher, Prof. Hadiza Shehu Galadanci, highlighted three major causes of PPH: missed or delayed diagnosis, intervals of interventions, and delays in making final decisions. The stories also emphasized the importance of early detection and training as essential strategies for addressing PPH, as most of these deaths could have been averted with optimal capacity among health workers.
Our continuous effort to strengthen the healthcare system and improve the quality of life remains steadfast. Through innovative projects and strategic collaborations, such as our ongoing Bill & Melinda Gates Foundation-funded project to support the rollout of key MNH innovations to reduce maternal and newborn deaths, ACE Strategy and Consults Ltd. is dedicated to supporting the country’s agenda to reduce maternal mortality, enhance healthcare delivery, ensure better health outcomes, and foster healthier communities.
Video Credits: CCSI - Centre for Communication and Social Impact#MaternalHealth#PPH#HealthcareInnovation#EMOTIVEIntervention#MaternalMortality#PublicHealth
About 14,000,000 women have postpartum hemorrhage globally. Postpartum hemorrhage is just 500 mils of blood loss after delivery within 24 hours. And out of that, 14,070,000 of them will die. And when you look at the global statistics, of all the women that die from maternal mortality, 25%, a quarter of them are as a result of postpartum hemorrhage. What is the cause of the pH? It might be due to uterine atony. It can be due to like tear, cervical laceration, perennial tear and soon and so forth. We have the interventions, we know how to prevent postpartum hemorrhage and how to treat it, but then it keeps on giving us the greatest burden as far as maternal health is concerned. We identify three reasons. The 1st is missed or delayed diagnosis. So when a woman delivers, we need to estimate the amount of blood she loses so that we know whether she has postpartum hemorrhage or not. And the only way we do that is by estimation, by what we call visual estimation. We look at the blood on her clothes, on the bed, on the floor, on the pads, and then we say she's lost 304 hundred, 506 hundred. And almost all the time we are wrong. Usually it's delayed that used to bring about the complication or maybe inaccuracy of the measure of the bloodlust. Initially we are just using an IQ, I will just say estimated blood loss. In fact, we have data that showed more than 50% of women are missed when they have 500 mills and up to 30% of women are missed. Actually when they have up to 1000 litre, they've lost up to 1000. So you can see the amount of, you know, missed diagnosis that we have. The second delay, is that OK? You pick that she has postpartum hemorrhage and then we have. I'll arrange of interventions, but what healthcare providers do is that they do one intervention and wait to see whether it will work. Like if you give the oxytocin fluid, you give a 10 period of time to see whether when you're the bleeding was stopped. And that period of time, the woman might tend to lose a lot of blood. And we realize that was also a problem which my little lot of complications like a human can fall into shock, some can even die. So the experience was something that gave me. He is each what am I? Am I going to see like shock, something that I never expected. I was like, hi, am I dying? It was like I am dying. I even swear at that moment that I am not going to deliver again. And then the third delay, it takes more time before they take a final decision of to take her to the theatre because it means it's a refractory bleeding. So all these delays makes, you know, us or the healthcare providers not actually give active management for pH. And therefore at the end of the day, we get women that have lost so much blood and then we cannot save them from dying. I lost a patient. As a result of pH. Because he bled and we did all everything possible to save this woman. We like we couldn't I last last last we have to last the woman. So whatever even the woman was the last week she told me she even hold my hand and she told me that please I should tell her husband that should take care of the kids for her. So that thing you really touches my heart and I I have to even shed tears that have really. So we now developed the emotive trial and the emotive trial is actually addressing these three divides. The east stands for early detection. And what did we do to do early detection? We put a drape so we can actually know the amount of blood she has lost and be able to start treatment. That's the E when you detect that home, this woman is having pH. Maybe she bled more than 500 miles of blood, so. Then you think I needed to trigger so that saved this woman. Then the motive. It's all the interventions that we've been doing. There is no new intervention in emotive. These are interventions that we already have already been proven to work. So what are they? M is for massage or is for oxytrol sex, Tea is for tranexamic acid, I is for Ivy fluids and the last E is for escalation. So what we are saying in emotive is that you use the drip for early detection and you give the bundle treatment, the MOTIVEU give it all at the same time. That is why the success is much higher than that of before that things are done one after the other. So you give all. And you give it within 15 minutes. Not really bring about the difference between the former system of control of pH and the one of present is keeping every item we need with respect to control of pH in a single place. So once we made mention that somebody is bleeding, you will stay out for help. I need help. Please let me have the emotive trolley. As soon as the trolley is being brought to your side, everything, virtually everything is there. All you may need to catch up or a patient with pH. Is right inside the trolley. I'm advising women that they should go to hospital and liver. Please my past previous deliveries I have no any complications so let me just delivered at home and any drive I know this this this and that. I don't use to take time when I started label but this one. It's for a long I was kid. I'm thinking I, I'm, I tell you that I'm thinking of losing my life. So. After I have delivered the my baby. So. Kuwait deep bleeding has just started. So I'm thinking, how will I? How will I see? I thank God the midwife that conducted the delivery, she was trained by the emotive, She knew how to administer the emotive vendors, so she triggered the bundles and the bleeding stopped. I was lucky before the delivery the lady I was there for the measurements. So after delivery they come to check their leader for the measurement of the blood. So they found out that the blood was much more so immediately after the. Take out the leader. They asked me to stand up maybe to so that they can lose it if I can do that. So I said I can do it is after coming down from the bed that I notice I was dizzy. I could not even do it. As I come down the blood starts coming out. The label was going and I have been asking the nurses what is going on, what this and that. They've been explaining. They were telling me to stay calm, everything is OK. I was told that she was going to be induced. You know what they Guzman means. So I have to ask what is it for? And they explain it to me. And I was convinced that it's going to help her. So I, I just signed the document that let's let it just go. So they asked me to go back immediately to the bed. They injected me. And so the trip was injected with different, different type of. Yeah, like it's yes, as soon as they apply it. I don't know something much more better, but I had the word of oxytocin. After that, blood was immediately transfused. There are some facilities now that have said since they started the emotive intervention, they've not had any woman died from postpartum hemorrhage. And before he motive intervention, they had two 3-4 before the introduction of emotive at times. Within M1G may have. 2-3 mortalities what it has reduced now drastically. With immutable I think no woman should die of people H and this intervention was a magic. We have all the support that is required. We have an intervention that works. We have complete, you know, buy in by the government. We have the political will. Therefore, the time is now for us to actually reduce the rate of severe PPH and therefore reduce the rate of women dying from postpartum hemorrhage. Healthy Child. LD Mola Healthy child, Healthy mother, Healthy child, healthy mother, healthy child.
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3moExcellent explanation with simple presentation of PPH Emotive bundles. Big thank you to ACEPHAP team.