Combatting Postpartum Haemorrhage: Roadmap and Call-to-Action

undefined
 
 
13 September 2023
Consensus from the Postpartum Haemorrhage Summit
A Roadmap and Call-to-Action to
Combat Postpartum Haemorrhage
from 2023 to 2030
 
Why do we need a PPH Roadmap?
Implementation barriers
Inconsistencies in guidance
Innovation deficit
Public health needs
PPH 
leading cause of
maternal death 
globally;
disproportionately 
higher
in LMICs
Several LMICs 
not on track
to meet SDG-3 targets
Stagnant PPH research
horizons
Only
 
two new PPH
medicines 
over the last 30
years
Fragmentation and
inconsistencies 
in
international and national
PPH guidelines
Lack of updated national
policies 
& low uptake
Multidimensional
implementation bottlenecks
beyond adoption of global
norms
Underutilization of advocacy
to catalyze global action
No PPH-focused global
agenda or coherent action
plans 
to guide stakeholders
undefined
130+ participants
50+ 
participating
countries
Diverse backgrounds
Reflective of PPH
diversity
undefined
 
 
The
Roadmap
 
 
 
How did we get here? Four strategic areas to catalyse action
What are
 the key
gaps in current
knowledge 
about
preventing,
detecting, and
managing PPH?
What kind of
research could
catalyse
innovation
?
Research
 Norms/Standards
Implementation
 
Advocacy
What 
new
guidelines
are needed to
fill gaps?
Where do
guidelines need
to be
harmonised to
eliminate
conflicts
?
Where is
implementation
breaking down or
getting stuck
?
What is needed to
get evidence-
based
interventions to
women who
need them most
?
How can
advocacy be
leveraged to
advance the PPH
agenda
?
What types of
advocacy could
galvanize action
on ending deaths
due to PPH?
 
 
 
Roadmap to accelerate progress on Postpartum Haemorrhage
Research
Norms &
Standards
Advocacy
All 
priority questions 
of
the research agenda have
been 
answered
Global guidelines 
reflect
latest evidence available,
and are cascaded into
national guidelines
, with
clear clinical protocols
Priority implementation
bottlenecks
 
and
 
hurdles
,
incl. context-specific ones,
have been 
removed
Successful 
engagement
 of
all target audiences
Objective
Q2 2023
PPH
Summit
Q3 2023
Q4 2023
H1 2024
H2 2024
2025
2026
2027
2028
2029
2030
Strategic areas
Implementation
 
 
 
Roadmap to accelerate progress on Postpartum Haemorrhage
Research
Norms &
Standards
Implementation
Advocacy
All 
priority questions 
of
the research agenda have
been 
answered
Global guidelines 
reflect
latest evidence available,
and are cascaded into
national guidelines
, with
clear clinical protocols
Successful 
engagement
 of
all target audiences
Objective
Q2 2023
Q3 2023
Q4 2023
PPH
Summit
PPH guideline 
adaptation and adoption
 to support dissemination and implementation in-country
Support authorization of full scope of practice for 
midwifery and other cadres; capacity building, professional development
H1 2024
H2 2024
2025
2026
2027
2028
2029
2030
Priority implementation
bottlenecks
 
and
 
hurdles
,
incl. context-specific ones,
have been 
removed
Strategic areas
 
 
 
Roadmap to accelerate progress on Postpartum Haemorrhage
Global branding strategy
and advocacy framework
Calls for proposals
 to
conduct top priority
research
All 
priority questions 
of
the research agenda have
been 
answered
Global guidelines 
reflect
latest evidence available,
and are cascaded into
national guidelines
, with
clear clinical protocols
Successful 
engagement
 of
all target audiences
Objective
Q2 2023
Q3 2023
Q4 2023
H1 2024
H2 2024
2025
2026
2027
2028
2029
2030
PPH
Summit
Publication of 
WHO
recommendations
 actioning
new, impactful evidence
Advocacy efforts
 to raise awareness and advocate for women to be at the centre of the political agenda
Launch 
PPH
Framework
Research
Norms &
Standards
Implementation
Advocacy
Priority implementation
bottlenecks
 
and
 
hurdles
,
incl. context-specific ones,
have been 
removed
PPH guideline 
adaptation and adoption
 to support dissemination and implementation in-country
Support authorization of full scope of practice for 
midwifery and other cadres; capacity building, professional development
Strategic areas
 
 
 
Roadmap to accelerate progress on Postpartum Haemorrhage
Global branding strategy
and advocacy framework
1
st
 Global
PPH day
Calls for proposals
 to
conduct top priority
research
Publication and updating of
consolidated guidelines and
derivative tools
All 
priority questions 
of
the research agenda have
been 
answered
Global guidelines 
reflect
latest evidence available,
and are cascaded into
national guidelines
, with
clear clinical protocols
Successful 
engagement
 of
all target audiences
Objective
Q2 2023
Q3 2023
Q4 2023
H1 2024
H2 2024
2025
2026
2027
2028
2029
2030
PPH
Summit
Publication of 
WHO
recommendations
 actioning
new, impactful evidence
Advocacy efforts
 to raise awareness and advocate for women to be at the centre of the political agenda
Launch common
measurement platform
Launch 
PPH
Framework
Research
Norms &
Standards
Implementation
Advocacy
Priority implementation
bottlenecks
 
and
 
hurdles
,
incl. context-specific ones,
have been 
removed
PPH guideline 
adaptation and adoption
 to support dissemination and implementation in-country
Support authorization of full scope of practice for 
midwifery and other cadres; capacity building, professional development
Strategic areas
 
 
 
Roadmap to accelerate progress on Postpartum Haemorrhage
Global branding strategy
and advocacy framework
1
st
 Global
PPH day
Calls for proposals
 to
conduct top priority
research
Publication and updating of
consolidated guidelines and
derivative tools
Publication & dissemination of results
completed for the first batch
 of funded
research for integration into global guidelines
All 
priority questions 
of
the research agenda have
been 
answered
Global guidelines 
reflect
latest evidence available,
and are cascaded into
national guidelines
, with
clear clinical protocols
Successful 
engagement
 of
all target audiences
Objective
Q2 2023
Q3 2023
Q4 2023
H1 2024
H2 2024
2025
2026
2027
2028
2029
2030
PPH
Summit
Publication of 
WHO
recommendations
 actioning
new, impactful evidence
Regional and local
advocacy framework
Advocacy efforts
 to raise awareness and advocate for women to be at the centre of the political agenda
New 
procurement
initiative
Launch common
measurement platform
Launch 
PPH
Framework
Research
Norms &
Standards
Implementation
Advocacy
Priority implementation
bottlenecks
 
and
 
hurdles
,
incl. context-specific ones,
have been 
removed
PPH guideline 
adaptation and adoption
 to support dissemination and implementation in-country
Support authorization of full scope of practice for 
midwifery and other cadres; capacity building, professional development
Strategic areas
 
 
 
Roadmap to accelerate progress on Postpartum Haemorrhage
Global branding strategy
and advocacy framework
1
st
 Global
PPH day
Calls for proposals
 to
conduct top priority
research
Publication and updating of
consolidated guidelines and
derivative tools
Publication & dissemination of results
completed for the first batch
 of funded
research for integration into global guidelines
Review of
pending/new
research gaps
All 
priority questions 
of
the research agenda have
been 
answered
Global guidelines 
reflect
latest evidence available,
and are cascaded into
national guidelines
, with
clear clinical protocols
Successful 
engagement
 of
all target audiences
Objective
Q2 2023
Q3 2023
Q4 2023
H1 2024
H2 2024
2025
2026
2027
2028
2029
2030
PPH
Summit
Publication of 
WHO
recommendations
 actioning
new, impactful evidence
Regional and local
advocacy framework
Update 
of
frameworks
Advocacy efforts
 to raise awareness and advocate for women to be at the centre of the political agenda
New 
procurement
initiative
Launch common
measurement platform
Launch 
PPH
Framework
Research
Norms &
Standards
Implementation
Advocacy
Priority implementation
bottlenecks
 
and
 
hurdles
,
incl. context-specific ones,
have been 
removed
PPH guideline 
adaptation and adoption
 to support dissemination and implementation in-country
Support authorization of full scope of practice for 
midwifery and other cadres; capacity building, professional development
Strategic areas
Q4 2023
2028
PUBLICATION AND UPDATING OF CONSOLIDATED GUIDELINES AND DERIVATIVE TOOLS
LEGEND
undefined
 
 
Since the soft
launch of the
Roadmap at
IMNHC, several
partners have
made important
commitments
FIGO 
and
 ICM 
have committed to working with WHO to
develop a joint, consolidated PPH guideline
USAID
 has committed to fund the development of the
WHO-FIGO-ICM joint, consolidated PPH guideline
Jhpiego
 and 
Laerdal Global Health 
have committed to
developing training, job aids, and other implementation
support materials to drive in-country implementation
of the WHO-FIGO-ICM joint, consolidated PPH guideline
RHSC 
and 
Monash
 have committed to supporting
efforts to enhance procurement of and access to
quality PPH commodities
USAID
 has committed to using its supply chain work to
strengthen access to PPH commodities and to working
with policymakers to include TXA in EMLs
AOFOG 
 has committed to facilitating country access to
low-cost heat-stable carbetocin in Asia and Oceania
RHSC
 and 
PPH CoP
 have committed to supporting
advocacy efforts and working with policymakers
undefined
 
 
In addition, WHO
has already
begun to make
progress against
its commitments
Meeting with partners to solidify commitments
against the Roadmap and determine roles and
responsibilities
Scoping existing funded research currently
underway related to the 15 top priority research
questions
Developing Target Policy Profiles to indicate how
research evidence responding to each of the priority
research questions can be translated into global
guidance
Identifying the potential scope of the WHO-FIGO-
ICM joint, consolidated PPH guideline and
underpinning evidence bases for potential
recommendations, in preparation for meeting of the
WHO Technical Advisory Group for Maternal and
Perinatal Health Guidelines before end of 2023
undefined
 
 
Communications and Dissemination Strategy
Soft launch at IMNHC in May 2023
Official publication by WHO and public
release at FIGO World Congress in
October 2023
Launch of online accountability platform
Additional dissemination through WHO
Regional Offices and at upcoming
conferences and events
 
 
undefined
 
 
Global Call-to-Action
targeting
 9
 categories
of stakeholders
Donors
Research
community
Industry &
innovators
Guideline
developers
Implementors
(incl. NGOs and CSOs)
Professional
associations
Ministries
of Health
International
community
Women and
women’s
groups
undefined
 
 
 
The development of the
Roadmap was funded MSD for
Mothers and the Bill & Melinda
Gates Foundation
Thank you!
 
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Postpartum haemorrhage (PPH) is a significant global health concern, particularly affecting low- and middle-income countries. The need for a comprehensive roadmap and call-to-action arises from public health needs, innovation deficits, inconsistent guidance, implementation barriers, and the high maternal mortality rates linked to PPH. The lack of updated policies, research stagnation, and fragmented guidelines further underscore the urgency for collective action. The roadmap discussed at the Postpartum Haemorrhage Summit 2023 aims to address these challenges through strategic areas like norms/standards, advocacy, research, and implementation. By leveraging advocacy, harmonizing guidelines, filling knowledge gaps, and catalyzing innovation, stakeholders can accelerate progress towards the goal of combatting PPH by 2030.


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  1. A Roadmap and Call-to-Action to Combat Postpartum Haemorrhage from 2023 to 2030 Consensus from the Postpartum Haemorrhage Summit 13 September 2023

  2. Why do we need a PPH Roadmap? Public health needs Innovation deficit Inconsistencies in guidance Implementation barriers PPH leading cause of maternal death globally; disproportionately higher in LMICs Several LMICs not on track to meet SDG-3 targets Stagnant PPH research horizons Onlytwo new PPH medicines over the last 30 years Fragmentation and inconsistencies in international and national PPH guidelines Lack of updated national policies & low uptake Multidimensional implementation bottlenecks beyond adoption of global norms Underutilization of advocacy to catalyze global action No PPH-focused global agenda or coherent action plans to guide stakeholders 1

  3. 1 3 0 + p a r t i c i p a n t s 50+ participating countries Reflective of PPH diversity Diverse backgrounds Industry and Private Sector Ministries of Health Academic Researchers Non-Governmental Organizations Professional Associations International donors UN Agencies and Partnerships 2

  4. The Roadmap 3

  5. How did we get here? Four strategic areas to catalyse action Norms/Standards Advocacy Research Implementation How can advocacy be leveraged to advance the PPH agenda? Where is implementation breaking down or getting stuck? What new guidelines are needed to fill gaps? What are the key gaps in current knowledge about preventing, detecting, and managing PPH? What is needed to get evidence- based interventions to women who need them most? Where do guidelines need to be harmonised to eliminate conflicts? What types of advocacy could galvanize action on ending deaths due to PPH? What kind of research could catalyse innovation? 4

  6. Roadmap to accelerate progress on Postpartum Haemorrhage PPH Summit Q2 2023 Q3 2023 Q4 2023 H1 2024 H2 2024 2025 2026 2027 2028 2029 2030 Objective All priority questions of the research agenda have been answered Research Global guidelines reflect latest evidence available, and are cascaded into national guidelines, with clear clinical protocols Norms & Standards IMNHC launch of the RoadMap, including research, normative, implementation, and advocacy agendas Strategic areas Priority implementation bottlenecksandhurdles, incl. context-specific ones, have been removed Implementation Successful engagement of all target audiences Advocacy 5 Interdependencies Milestones non contingent on new funding Milestones contingent on funding

  7. Roadmap to accelerate progress on Postpartum Haemorrhage PPH Summit Q2 2023 Q3 2023 Q4 2023 H1 2024 H2 2024 2025 2026 2027 2028 2029 2030 Objective All priority questions of the research agenda have been answered Research Global guidelines reflect latest evidence available, and are cascaded into national guidelines, with clear clinical protocols Norms & Standards IMNHC launch of the RoadMap, including research, normative, implementation, and advocacy agendas Strategic areas PPH guideline adaptation and adoption to support dissemination and implementation in-country Priority implementation bottlenecksandhurdles, incl. context-specific ones, have been removed Support authorization of full scope of practice for midwifery and other cadres; capacity building, professional development Implementation Successful engagement of all target audiences Advocacy 6 Interdependencies Milestones non contingent on new funding Milestones contingent on funding

  8. Roadmap to accelerate progress on Postpartum Haemorrhage PPH Summit Q2 2023 Q3 2023 Q4 2023 H1 2024 H2 2024 2025 2026 2027 2028 2029 2030 Objective All priority questions of the research agenda have been answered Calls for proposals to conduct top priority research Research Global guidelines reflect latest evidence available, and are cascaded into national guidelines, with clear clinical protocols Publication of WHO recommendations actioning new, impactful evidence Norms & Standards IMNHC launch of the RoadMap, including research, normative, implementation, and advocacy agendas Strategic areas PPH guideline adaptation and adoption to support dissemination and implementation in-country Priority implementation bottlenecksandhurdles, incl. context-specific ones, have been removed Support authorization of full scope of practice for midwifery and other cadres; capacity building, professional development Implementation Launch PPH Framework Advocacy efforts to raise awareness and advocate for women to be at the centre of the political agenda Successful engagement of all target audiences Advocacy Global branding strategy and advocacy framework 7 Interdependencies Milestones non contingent on new funding Milestones contingent on funding

  9. Roadmap to accelerate progress on Postpartum Haemorrhage PPH Summit Q2 2023 Q3 2023 Q4 2023 H1 2024 H2 2024 2025 2026 2027 2028 2029 2030 Objective All priority questions of the research agenda have been answered Calls for proposals to conduct top priority research Research Global guidelines reflect latest evidence available, and are cascaded into national guidelines, with clear clinical protocols Publication of WHO recommendations actioning new, impactful evidence Publication and updating of consolidated guidelines and derivative tools Norms & Standards IMNHC launch of the RoadMap, including research, normative, implementation, and advocacy agendas Strategic areas PPH guideline adaptation and adoption to support dissemination and implementation in-country Priority implementation bottlenecksandhurdles, incl. context-specific ones, have been removed Support authorization of full scope of practice for midwifery and other cadres; capacity building, professional development Implementation Launch common measurement platform Launch PPH Framework Advocacy efforts to raise awareness and advocate for women to be at the centre of the political agenda Successful engagement of all target audiences Advocacy 1st Global PPH day Global branding strategy and advocacy framework 8 Interdependencies Milestones non contingent on new funding Milestones contingent on funding

  10. Roadmap to accelerate progress on Postpartum Haemorrhage PPH Summit Q2 2023 Q3 2023 Q4 2023 H1 2024 H2 2024 2025 2026 2027 2028 2029 2030 Objective All priority questions of the research agenda have been answered Calls for proposals to conduct top priority research Publication & dissemination of results completed for the first batch of funded research for integration into global guidelines Research Global guidelines reflect latest evidence available, and are cascaded into national guidelines, with clear clinical protocols Publication of WHO recommendations actioning new, impactful evidence Publication and updating of consolidated guidelines and derivative tools Norms & Standards IMNHC launch of the RoadMap, including research, normative, implementation, and advocacy agendas Strategic areas PPH guideline adaptation and adoption to support dissemination and implementation in-country Priority implementation bottlenecksandhurdles, incl. context-specific ones, have been removed Support authorization of full scope of practice for midwifery and other cadres; capacity building, professional development Implementation New procurement initiative Launch common measurement platform Launch PPH Framework Advocacy efforts to raise awareness and advocate for women to be at the centre of the political agenda Successful engagement of all target audiences Advocacy 1st Global PPH day Global branding strategy and advocacy framework Regional and local advocacy framework 9 Interdependencies Milestones non contingent on new funding Milestones contingent on funding

  11. Roadmap to accelerate progress on Postpartum Haemorrhage PPH Summit Q2 2023 Q3 2023 Q4 2023 H1 2024 H2 2024 2025 2026 2027 2028 2029 2030 Objective All priority questions of the research agenda have been answered Calls for proposals to conduct top priority research Publication & dissemination of results completed for the first batch of funded research for integration into global guidelines Review of pending/new research gaps Research Global guidelines reflect latest evidence available, and are cascaded into national guidelines, with clear clinical protocols Publication of WHO recommendations actioning new, impactful evidence Publication and updating of consolidated guidelines and derivative tools Norms & Standards IMNHC launch of the RoadMap, including research, normative, implementation, and advocacy agendas Strategic areas PPH guideline adaptation and adoption to support dissemination and implementation in-country Priority implementation bottlenecksandhurdles, incl. context-specific ones, have been removed Support authorization of full scope of practice for midwifery and other cadres; capacity building, professional development Implementation New procurement initiative Launch common measurement platform Launch PPH Framework Advocacy efforts to raise awareness and advocate for women to be at the centre of the political agenda Successful engagement of all target audiences Advocacy 1st Global PPH day Global branding strategy and advocacy framework Regional and local advocacy framework Update of frameworks 10 Interdependencies Milestones non contingent on new funding Milestones contingent on funding

  12. Global branding strategy and advocacy framework Regional and local advocacy frameworks Update of advocacy frameworks Publication of results of first batch of priority funded research Soft launch of the PPH Roadmap Call for proposals to conduct top priority research 1st Global PPH Day Review of pending/ new research gaps Q2 2023 Q3 2023 Q4 2023 H1 2024 H2 2024 2025 2026 2027 2028 2029 2030 WHO official publication of the Roadmap End of scoping exercise of longer-term solutions New procurement initiative LEGEND Research Launch common measurement platform Norms Implementation Advocacy Publication of WHO recommendations actioning new, impactful evidence PUBLICATION AND UPDATING OF CONSOLIDATED GUIDELINES AND DERIVATIVE TOOLS

  13. FIGO and ICM have committed to working with WHO to develop a joint, consolidated PPH guideline USAID has committed to fund the development of the WHO-FIGO-ICM joint, consolidated PPH guideline Jhpiego and Laerdal Global Health have committed to developing training, job aids, and other implementation support materials to drive in-country implementation of the WHO-FIGO-ICM joint, consolidated PPH guideline RHSC and Monash have committed to supporting efforts to enhance procurement of and access to quality PPH commodities USAID has committed to using its supply chain work to strengthen access to PPH commodities and to working with policymakers to include TXA in EMLs AOFOG has committed to facilitating country access to low-cost heat-stable carbetocin in Asia and Oceania RHSC and PPH CoP have committed to supporting advocacy efforts and working with policymakers Since the soft launch of the Roadmap at IMNHC, several partners have made important commitments 12

  14. Meeting with partners to solidify commitments against the Roadmap and determine roles and responsibilities Scoping existing funded research currently underway related to the 15 top priority research questions In addition, WHO has already begun to make progress against its commitments Developing Target Policy Profiles to indicate how research evidence responding to each of the priority research questions can be translated into global guidance Identifying the potential scope of the WHO-FIGO- ICM joint, consolidated PPH guideline and underpinning evidence bases for potential recommendations, in preparation for meeting of the WHO Technical Advisory Group for Maternal and Perinatal Health Guidelines before end of 2023 13

  15. Communications and Dissemination Strategy Soft launch at IMNHC in May 2023 Official publication by WHO and public release at FIGO World Congress in October 2023 Launch of online accountability platform Additional dissemination through WHO Regional Offices and at upcoming conferences and events 14

  16. Women and women s groups Ministries of Health Donors Implementors (incl. NGOs and CSOs) Global Call-to-Action targeting 9 categories of stakeholders International community Industry & innovators Research community Professional associations Guideline developers 15

  17. The development of the Roadmap was funded MSD for Mothers and the Bill & Melinda Gates Foundation Thank you! 16

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