Development, Field-Testing and Piloting of a refractory postpartum haemorrhage management package: the PPH ReAct (PPH Refractory Action) study
Lead Research Organisation:
University of Birmingham
Department Name: Inst of Metabolism & Systems Research
Abstract
Every six minutes a mother dies from excessive bleeding after childbirth in low-resource countries, in the prime of her life and often leaving behind a young family. When a mother dies in childbirth, her infant has less than a 20% chance of surviving past the first month. Excessive bleeding after childbirth, or postpartum haemorrhage (PPH), is the commonest reason why mothers die worldwide. Effective treatment can stop bleeding in most women. However, those who continue to bleed despite 'first response' treatment are thought to have refractory PPH and are the women who die or suffer major complications. We have developed a provisional management package for these women, called the 'PPH ReAct' package. We wish to refine this management package, develop an implementation strategy for this, field-test these and finally pilot the approach in 5 health facilities in Kenya.
The WHO published "Recommendations for the Prevention and Treatment of Postpartum Hemorrhage" in 2012 to provide evidence-informed recommendations for managing PPH. However, adherence to these recommendations is currently limited by a number of challenges.
Challenges and proposed solutions
1) Many women continue to bleed despite 'first response' management of PPH --> Solution: A refractory PPH treatment package
2) Delayed or inconsistent use of treatments for refractory PPH management --> Solution: A refractory PPH management (the PPH ReAct) package that uses simplified approaches and a checklist to ensure consistent and timely assessments and treatments.
3) Many care providers and organisations struggle to provide effective care for women with refractory PPH, despite treatments being available --> Solution: Deeper understanding of challenges, and a strategy for changing behaviours of healthcare professionals and organisations using behavioural science frameworks.
4) Lack of evidence and confidence that the proposed approach can improve usage of effective treatments for treatment of refractory PPH --> Solution: A study for the refractory PPH treatment package to ensure an increase usage of life-saving treatment by the healthcare professionals and organisations. This study could generate the necessary evidence that will give healthcare practitioners and policy makers the confidence to implement and scale-up the programme.
5) Limited scale-up and coverage --> Solution: Engagement of strong partners: World Health Organisation, Jhpiego, Behavioural Scientists, Health Ministries and Concept Foundation
Our aim is to develop, refine and evaluate an effective approach to managing refractory PPH. Despite concentrated efforts, PPH remains the leading cause why mothers die or suffer major complications during childbirth. Most women with PPH respond to initial treatments. However, a substantial number of women do not, and these are the women who suffer die or suffer major complications. There is an unmet need to define the optimal approach for managing refractory PPH. Furthermore, a management approach could achieve its intended goals only if it is widely accepted and used in everyday practice; thus a meaningful strategy for implementing this approach is necessary. We therefore propose the development, refinement and piloting of a refractory PPH management package and implementation strategy.
The WHO published "Recommendations for the Prevention and Treatment of Postpartum Hemorrhage" in 2012 to provide evidence-informed recommendations for managing PPH. However, adherence to these recommendations is currently limited by a number of challenges.
Challenges and proposed solutions
1) Many women continue to bleed despite 'first response' management of PPH --> Solution: A refractory PPH treatment package
2) Delayed or inconsistent use of treatments for refractory PPH management --> Solution: A refractory PPH management (the PPH ReAct) package that uses simplified approaches and a checklist to ensure consistent and timely assessments and treatments.
3) Many care providers and organisations struggle to provide effective care for women with refractory PPH, despite treatments being available --> Solution: Deeper understanding of challenges, and a strategy for changing behaviours of healthcare professionals and organisations using behavioural science frameworks.
4) Lack of evidence and confidence that the proposed approach can improve usage of effective treatments for treatment of refractory PPH --> Solution: A study for the refractory PPH treatment package to ensure an increase usage of life-saving treatment by the healthcare professionals and organisations. This study could generate the necessary evidence that will give healthcare practitioners and policy makers the confidence to implement and scale-up the programme.
5) Limited scale-up and coverage --> Solution: Engagement of strong partners: World Health Organisation, Jhpiego, Behavioural Scientists, Health Ministries and Concept Foundation
Our aim is to develop, refine and evaluate an effective approach to managing refractory PPH. Despite concentrated efforts, PPH remains the leading cause why mothers die or suffer major complications during childbirth. Most women with PPH respond to initial treatments. However, a substantial number of women do not, and these are the women who suffer die or suffer major complications. There is an unmet need to define the optimal approach for managing refractory PPH. Furthermore, a management approach could achieve its intended goals only if it is widely accepted and used in everyday practice; thus a meaningful strategy for implementing this approach is necessary. We therefore propose the development, refinement and piloting of a refractory PPH management package and implementation strategy.
Technical Summary
Every six minutes a mother dies from postpartum haemorrhage (PPH) in low-resource countries, in the prime of her life and often leaving behind a young family. When a mother dies in childbirth, her infant has less than a 20% chance of surviving past the first month. PPH is the commonest reason maternal deaths worldwide. Effective first-line treatment can stop bleeding in most women diagnosed with PPH. However, those who continue to bleed despite first-line treatment are the women who suffer major morbidity and mortality. We have developed a provisional management package for refractory PPH, called the 'PPH ReAct' package. We wish to refine this management package, develop an implementation strategy for this, field-test these and finally pilot the approach in 5 health facilities in Kenya.
Our objectives are:
Objective 1: Refine the 'ReAct' refractory PPH management package through evidence synthesis, stakeholder engagement, and expert technical consultations.
Objective 2: Develop an implementation strategy for refractory PPH management, through mixed-methods research, and a consensus-building co-design workshop.
Objective 3: Field-test the refractory PPH management package and the implementation strategy in two health facilities in Kenya, through qualitative and quantitative methods.
Objective 4: Pilot the refractory PPH management package and implementation strategy from objective 3 in five health facilities in Kenya, to evaluate its effects on process outcomes, as well as explore the feasibility of conducting a large scale implementation trial.
Our objectives are:
Objective 1: Refine the 'ReAct' refractory PPH management package through evidence synthesis, stakeholder engagement, and expert technical consultations.
Objective 2: Develop an implementation strategy for refractory PPH management, through mixed-methods research, and a consensus-building co-design workshop.
Objective 3: Field-test the refractory PPH management package and the implementation strategy in two health facilities in Kenya, through qualitative and quantitative methods.
Objective 4: Pilot the refractory PPH management package and implementation strategy from objective 3 in five health facilities in Kenya, to evaluate its effects on process outcomes, as well as explore the feasibility of conducting a large scale implementation trial.
Planned Impact
1. Impacts on health and wellbeing of mothers
Every year about 14 million women around the world suffer from PPH. An estimated 303,000 women died during childbirth in 2015 with PPH accounting for up to a third of all these deaths. Maternal deaths remain excessively high in resource poor countries because many women do not receive timely treatment. Most women with PPH respond to first line treatments. However, a substantial number of women do not, and these are the women who suffer morbidity and mortality. There is an unmet need to define the optimal approach for managing refractory PPH. Our aim is to develop, refine and evaluate an effective approach to managing refractory PPH. Furthermore, a management approach could achieve its intended goals only if it is widely accepted and used in everyday practice; thus a meaningful implementation strategy is necessary. We therefore propose the development, refinement and piloting of a refractory PPH management package and implementation strategy.
2. Impact on public policy, law and services
We are working closely together with policy makers and are linked with in-country Ministries of Health so we can advise about the implementation of the emerging evidence on the effectiveness of the proposed approach.
3. Impact on social welfare
Women who are poor, least educated, and who reside in rural areas have lower health intervention coverage and worse health outcomes than more advantaged women. Reducing childbirth complications and maternal deaths related to PPH by using a more effective treatment approach could have a positive impact on health equity and improve outcomes among disadvantaged.
4. Impacts on practitioners and professional services
A key ongoing impact of this work has been its use by charities and professional societies such as Jhpiego, Concept Foundation and Ammalife, which have been very quick to recognise the potential of such an approach. These groups could lead the campaign for its routine use in LMIC.
5. Impacts on commerce and the economy
A successful approach for treating women with refractory PPH could have an impact on the budgets of the target health facilities as most women could be saved from bleeding and avoid birth complications. Most women would require simple timely and effective treatments and could avoid invasive and expensive interventions.
6. Impact to in-country academic institutions
Capacity building within the recruiting countries is an important part of this research trial. We will ensure there is effective mentorship, professional development opportunities and training to support and develop academic staff. Specific capacity building funds have also been included for University of Nairobi and they will work closely with the Birmingham Clinical Trials Unit to enhance their organisation. We anticipate this positive legacy should last well beyond the duration of the study.
Every year about 14 million women around the world suffer from PPH. An estimated 303,000 women died during childbirth in 2015 with PPH accounting for up to a third of all these deaths. Maternal deaths remain excessively high in resource poor countries because many women do not receive timely treatment. Most women with PPH respond to first line treatments. However, a substantial number of women do not, and these are the women who suffer morbidity and mortality. There is an unmet need to define the optimal approach for managing refractory PPH. Our aim is to develop, refine and evaluate an effective approach to managing refractory PPH. Furthermore, a management approach could achieve its intended goals only if it is widely accepted and used in everyday practice; thus a meaningful implementation strategy is necessary. We therefore propose the development, refinement and piloting of a refractory PPH management package and implementation strategy.
2. Impact on public policy, law and services
We are working closely together with policy makers and are linked with in-country Ministries of Health so we can advise about the implementation of the emerging evidence on the effectiveness of the proposed approach.
3. Impact on social welfare
Women who are poor, least educated, and who reside in rural areas have lower health intervention coverage and worse health outcomes than more advantaged women. Reducing childbirth complications and maternal deaths related to PPH by using a more effective treatment approach could have a positive impact on health equity and improve outcomes among disadvantaged.
4. Impacts on practitioners and professional services
A key ongoing impact of this work has been its use by charities and professional societies such as Jhpiego, Concept Foundation and Ammalife, which have been very quick to recognise the potential of such an approach. These groups could lead the campaign for its routine use in LMIC.
5. Impacts on commerce and the economy
A successful approach for treating women with refractory PPH could have an impact on the budgets of the target health facilities as most women could be saved from bleeding and avoid birth complications. Most women would require simple timely and effective treatments and could avoid invasive and expensive interventions.
6. Impact to in-country academic institutions
Capacity building within the recruiting countries is an important part of this research trial. We will ensure there is effective mentorship, professional development opportunities and training to support and develop academic staff. Specific capacity building funds have also been included for University of Nairobi and they will work closely with the Birmingham Clinical Trials Unit to enhance their organisation. We anticipate this positive legacy should last well beyond the duration of the study.
Organisations
- University of Birmingham (Lead Research Organisation, Project Partner)
- Muhimbili University of Health and Allied Sciences (Collaboration)
- Concept Foundation (Collaboration, Project Partner)
- Institute for Clinical Effectiveness and Health Policy (Collaboration)
- Wits Health Consortium (Collaboration)
- ST GEORGE'S UNIVERSITY OF LONDON (Collaboration)
- Leiden University Medical Center (Collaboration)
- UNIVERSITY OF ABERDEEN (Collaboration)
- Fundacion Clinica Valle del Lili, Cali (Collaboration)
- KHON KAEN UNIVERSITY (Collaboration)
- Johns Hopkins University (Collaboration)
- International Confederation of Midwives (Collaboration)
- Bill & Melinda Gates Foundation (Collaboration)
- UNIVERSITY OF BIRMINGHAM (Collaboration)
- BAYERO UNIVERSITY KANO (Collaboration)
- University of the Republic (Collaboration)
- International Federation of Gynecology and Obstetrics (FIGO) (Collaboration)
- UNIVERSITY OF LIVERPOOL (Collaboration)
- Fudan University (Collaboration)
- University of Cape Town (Collaboration)
- UNIVERSITY OF NAIROBI (Collaboration)
- Jhpiego (Collaboration, Project Partner)
- Universidade de São Paulo (Collaboration)
- World Health Organization (WHO) (Collaboration)
- University College London (Collaboration)
- French Institute of Rabat (Collaboration)
- The UK Sepsis Trust (Collaboration)
- UNIVERSITY OF OXFORD (Collaboration)
- Aga Khan University (Collaboration)
- University of Melbourne (Collaboration, Project Partner)
- University of Uyo Teaching Hospital (Collaboration)
- Center for Perinatal Studies, Rosarino (CREP) (Collaboration)
- UNIVERSITY OF PRETORIA (Collaboration)
- Lutheran Aid to Medicine in Bangladesh Hospital (Collaboration)
- University of Washington (Collaboration)
- United Nations Population Fund (Collaboration)
- KING'S COLLEGE LONDON (Collaboration)
- World Health Organization (Project Partner)
- University College London (Project Partner)
- University of Nairobi (Project Partner)
- University of California, San Francisco (Project Partner)
Publications
Akter S
(2022)
Detection and management of postpartum haemorrhage: Qualitative evidence on healthcare providers' knowledge and practices in Kenya, Nigeria, and South Africa.
in Frontiers in global women's health
Ammerdorffer A
(2022)
Quality of oxytocin and tranexamic acid for the prevention and treatment of postpartum hemorrhage in Kenya, Nigeria, South Africa, and Tanzania.
in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
Bohren MA
(2021)
Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol.
in Reproductive health
Forbes G
(2023)
Factors influencing postpartum haemorrhage detection and management and the implementation of a new postpartum haemorrhage care bundle (E-MOTIVE) in Kenya, Nigeria, and South Africa.
in Implementation science : IS
Hemming K
(2021)
Interim data monitoring in cluster randomised trials: Practical issues and a case study.
in Clinical trials (London, England)
Lambert P
(2023)
The compatibility of oxytocin and tranexamic acid injection products when mixed for co-administration by infusion for the treatment of postpartum haemorrhage: An in vitro investigation.
in BJOG : an international journal of obstetrics and gynaecology
Moran NF
(2023)
Tranexamic acid at cesarean delivery: drug-error deaths.
in American journal of obstetrics and gynecology
Parry-Smith W
(2021)
Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases
in Journal of Psychiatric Research
Wakili AA
(2022)
Differences in obstetric practices and outcomes of postpartum hemorrhage across Nigerian health facilities.
in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
| Title | MORE THAN BLOOD. PPH treatment with the E-MOTIVE bundle |
| Description | Short film highlighting the issue of post partum haemorrhage (PPH) in LMIC countries and implementation of the EMOTIVE bundle. |
| Type Of Art | Film/Video/Animation |
| Year Produced | 2022 |
| Impact | Increase in awareness of post partum haemorrhage (PPH) in LMIC countries and the creation of interventions suitable for use in LMIC settings. |
| URL | https://www.youtube.com/watch?v=axEeGl0FDGk |
| Description | Early detection of postpartum haemorrhage and treatment using the World Health Organization MOTIVE 'first response' bundle: a cluster randomised trial with health economic analysis and mixed-methods evaluation |
| Amount | $15,328,448 (USD) |
| Funding ID | INV-001393 |
| Organisation | Bill and Melinda Gates Foundation |
| Sector | Charity/Non Profit |
| Country | United States |
| Start | 01/2020 |
| End | 06/2024 |
| Title | Natural history model for PPH |
| Description | A model to assess the effect of improving specific clinical risks to prevent PPH |
| Type Of Material | Data analysis technique |
| Year Produced | 2023 |
| Provided To Others? | No |
| Impact | None to date |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Aga Khan University |
| Country | Pakistan |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Bayero University Kano |
| Country | Nigeria |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Bill and Melinda Gates Foundation |
| Country | United States |
| Sector | Charity/Non Profit |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Concept Foundation |
| Country | Thailand |
| Sector | Charity/Non Profit |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Institute for Clinical Effectiveness and Health Policy |
| Country | Argentina |
| Sector | Public |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Jhpiego |
| Country | United States |
| Sector | Charity/Non Profit |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | King's College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Muhimbili University of Health and Allied Sciences |
| Country | Tanzania, United Republic of |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | University College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | University of Cape Town |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | University of Liverpool |
| Department | School of Medicine Liverpool |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | University of Melbourne |
| Country | Australia |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | University of Nairobi |
| Country | Kenya |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | Wits Health Consortium |
| Country | South Africa |
| Sector | Private |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Global Post Partum Haemorrhage Research Network |
| Organisation | World Health Organization (WHO) |
| Department | Department of Reproductive Health and Research |
| Country | Global |
| Sector | Academic/University |
| PI Contribution | The strategic goal for our program is a reduction in morbidity and mortality from postpartum hemorrhage (PPH) for women giving birth in healthcare facilities in low- and middle-income countries (LMICs) over the next 5 years. This strategic goal will be met through activities (given below), which will result in a number of outputs and intermediate outcomes, culminating in the primary and other key outcomes. The primary outcome is a 25% reduction in severe PPH, laparotomy for bleeding, or mortality from bleeding, through a cluster randomized trial across 90 health facilities (276,000 women) in Kenya, Tanzania, Nigeria, South Africa, and Pakistan. The central coordinating team at the University of Birmingham are leading this programme to deliver these objectives. |
| Collaborator Contribution | WHO are involved with policy development. UCL and the University of Melbourne are conducting mixed methods implementation research. Kings College London and the University of Liverpool are providing clinical expertise on post partum haemorrhage. Concept foundation are testing drug quality at participating hospitals. African and South Asian countries are coordinating research activities and data collection at participating hospitals |
| Impact | Publications Interim data monitoring in cluster randomised trials: Practical issues and a case study. Hemming K, Martin J, Gallos I, Coomarasamy A, Middleton L. Clin Trials. 2021 Oct;18(5):552-561. doi: 10.1177/17407745211024751. Epub 2021 Jun 22 Formative research to design an implementation strategy for a postpartum hemorrhage initial response treatment bundle (E-MOTIVE): study protocol. Bohren MA, Lorencatto F, Coomarasamy A, Althabe F, Devall AJ, Evans C, Oladapo OT, Lissauer D, Akter S, Forbes G, Thomas E, Galadanci H, Qureshi Z, Fawcus S, Hofmeyr GJ, Al-Beity FA, Kasturiratne A, Kumarendran B, Mammoliti KM, Vogel JP, Gallos I, Miller S. Reprod Health. 2021 Jul 14;18(1):149. doi: 10.1186/s12978-021-01162-3. Postpartum haemorrhage and risk of long-term hypertension and cardiovascular disease: an English population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Šumilo D, Subramanian A, Gokhale K, Okoth K, Gallos I, Coomarasamy A, Nirantharakumar K. BMJ Open. 2021 May 5;11(5):e041566. doi: 10.1136/bmjopen-2020-041566. Postpartum haemorrhage and risk of mental ill health: A population-based longitudinal study using linked primary and secondary care databases. Parry-Smith W, Okoth K, Subramanian A, Gokhale KM, Chandan JS, Humpston C, Coomarasamy A, Nirantharakumar K, Šumilo D. J Psychiatr Res. 2021 May;137:419-425. doi: 10.1016/j.jpsychires.2021.03.022. Epub 2021 Mar 18 |
| Start Year | 2019 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Aga Khan University |
| Country | Pakistan |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Center for Perinatal Studies, Rosarino (CREP) |
| Country | Argentina |
| Sector | Charity/Non Profit |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | French Institute of Rabat |
| Country | Morocco |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Fudan University |
| Department | Department of Maternal, Child and Adolescent Health |
| Country | China |
| Sector | Hospitals |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Fundacion Clinica Valle del Lili, Cali |
| Country | Colombia |
| Sector | Hospitals |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | International Confederation of Midwives |
| Country | Netherlands |
| Sector | Charity/Non Profit |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | International Federation of Gynecology and Obstetrics (FIGO) |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Jhpiego |
| Country | United States |
| Sector | Charity/Non Profit |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Johns Hopkins University |
| Department | Department of International Health |
| Country | United States |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Khon Kaen University |
| Country | Thailand |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Leiden University Medical Center |
| Department | Department of Obstetrics and Gynaecology |
| Country | Netherlands |
| Sector | Hospitals |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Lutheran Aid to Medicine in Bangladesh Hospital |
| Country | Bangladesh |
| Sector | Hospitals |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | St George's University of London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | UK Sepsis Trust |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | United Nations Population Fund |
| Country | United States |
| Sector | Public |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | Universidade de São Paulo |
| Department | Department of Social Medicine |
| Country | Brazil |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of Aberdeen |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of Birmingham |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of Nairobi |
| Department | Department of Obstetrics and Gynaecology |
| Country | Kenya |
| Sector | Hospitals |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of Oxford |
| Department | National Perinatal Epidemiology Unit Oxford |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of Pretoria |
| Department | MRC Maternal and Infant Health Care Strategies Research Unit |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of Uyo Teaching Hospital |
| Country | Nigeria |
| Sector | Hospitals |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of Washington |
| Department | Earth and Space Sciences |
| Country | United States |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | University of the Republic |
| Department | Faculty of Medicine |
| Country | Uruguay |
| Sector | Academic/University |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | Maternal and Newborn Sepsis |
| Organisation | World Health Organization (WHO) |
| Country | Global |
| Sector | Public |
| PI Contribution | My team collaborates internationally to raise awareness of maternal and newborn sepsis, and to develop effective diagnostic tools and management strategies. |
| Collaborator Contribution | With our collaborative partners, we aim to build global consensus on key issues such as the definition of maternal sepsis and its validation in low and middle income countries. We also aim to strengthen international communities of healthcare professionals and researchers with expertise of relevance to maternal sepsis. |
| Impact | Outputs are published: DOI 10.1186/s12978-017-0321-6 and http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/maternalsepsis-statement/en/. |
| Start Year | 2015 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Aga Khan University |
| Country | Pakistan |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Bayero University Kano |
| Country | Nigeria |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Bill and Melinda Gates Foundation |
| Country | United States |
| Sector | Charity/Non Profit |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Concept Foundation |
| Country | Thailand |
| Sector | Charity/Non Profit |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Institute for Clinical Effectiveness and Health Policy |
| Country | Argentina |
| Sector | Public |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | International Confederation of Midwives |
| Country | Netherlands |
| Sector | Charity/Non Profit |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | International Federation of Gynecology and Obstetrics (FIGO) |
| Country | United Kingdom |
| Sector | Charity/Non Profit |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Jhpiego |
| Country | United States |
| Sector | Charity/Non Profit |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Muhimbili University of Health and Allied Sciences |
| Country | Tanzania, United Republic of |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | University College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | University College London |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | University of Cape Town |
| Country | South Africa |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | University of Liverpool |
| Country | United Kingdom |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | University of Melbourne |
| Country | Australia |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | University of Nairobi |
| Country | Kenya |
| Sector | Academic/University |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | Wits Health Consortium |
| Country | South Africa |
| Sector | Private |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | The Lancet PPH series collaborating group |
| Organisation | World Health Organization (WHO) |
| Country | Global |
| Sector | Public |
| PI Contribution | The University of Birmingham team, led by Prof Arri Coomarasamy, are leading the development and publication of a three-paper series in The Lancet that summarises the latest evidence on the incidence, prevention and treatment of postpartum haemorrhage. Prof Coomarasamy is the lead author for all three papers, and is also leading the evidence synthesis work that will contribute to this work. |
| Collaborator Contribution | Each partner is contributing to deciding on the clinical and policy recommendations that will be included in this series. |
| Impact | None |
| Start Year | 2022 |
| Description | WHO Collaborating Centre |
| Organisation | World Health Organization (WHO) |
| Country | Global |
| Sector | Public |
| PI Contribution | We are testing and disseminating a sepsis management bundle and tools for the initial care of maternal sepsis, firstly in multiple health facilities in Malawi and subsequently at scale in multiple low resource countries. We are also contributing to evidence-based guidelines for the prevention and treatment of PPH, and developing a bundle for the management of this condition. Finally, we are pursuing evidence synthesis of treatment options managing miscarriages. |
| Collaborator Contribution | The WHO supports our team in tasks above, through operational co-operation and advice in data analysis. |
| Impact | No outputs yet |
| Start Year | 2018 |
| Title | E-MOTIVE care bundle |
| Description | E-MOTIVE is a multi-country, parallel cluster randomised trial with a baseline control phase, along with mixed-methods and health economic evaluations. Eighty secondary level health facilities will take part in the trial. Initially, all health facilities will enter a 7-month baseline period in which they will be following usual care. After this, we will randomise 40 of the 80 health facilities to the E-MOTIVE intervention for 7 months, allowing two months for transition. The other 40 health facilities will continue to follow usual care as per the baseline period for the entire trial duration (16 months). The proposed sample size for data collection will be 215,040 women. |
| Type | Preventative Intervention - Behavioural risk modification |
| Current Stage Of Development | Late clinical evaluation |
| Year Development Stage Completed | 2019 |
| Development Status | Under active development/distribution |
| Clinical Trial? | Yes |
| UKCRN/ISCTN Identifier | PACTR202002791391791 |
| Impact | None to date |
| Title | ReAct care bundle pilot |
| Description | Every six minutes a mother dies from excessive bleeding after childbirth in low-resource countries, in the prime of her life and often leaving behind a young family. When a mother dies in childbirth, her infant has less than a 20% chance of surviving past the first month. Excessive bleeding after childbirth, or postpartum haemorrhage (PPH), is the commonest reason why mothers die worldwide. Effective treatment can stop bleeding in most women. However, those who continue to bleed despite 'first response' treatment are thought to have refractory PPH and are the women who die or suffer major complications. We have developed a provisional management package for these women, called the 'PPH ReAct' package. We wish to refine this management package, develop an implementation strategy for this, field-test these and finally pilot the approach in 5 health facilities in Kenya. The WHO published "Recommendations for the Prevention and Treatment of Postpartum Hemorrhage" in 2012 to provide evidence-informed recommendations for managing PPH. However, adherence to these recommendations is currently limited by a number of challenges. Challenges and proposed solutions 1) Many women continue to bleed despite 'first response' management of PPH --> Solution: A refractory PPH treatment package 2) Delayed or inconsistent use of treatments for refractory PPH management --> Solution: A refractory PPH management (the PPH ReAct) package that uses simplified approaches and a checklist to ensure consistent and timely assessments and treatments. 3) Many care providers and organisations struggle to provide effective care for women with refractory PPH, despite treatments being available --> Solution: Deeper understanding of challenges, and a strategy for changing behaviours of healthcare professionals and organisations using behavioural science frameworks. 4) Lack of evidence and confidence that the proposed approach can improve usage of effective treatments for treatment of refractory PPH --> Solution: A study for the refractory PPH treatment package to ensure an increase usage of life-saving treatment by the healthcare professionals and organisations. This study could generate the necessary evidence that will give healthcare practitioners and policy makers the confidence to implement and scale-up the programme. 5) Limited scale-up and coverage --> Solution: Engagement of strong partners: World Health Organisation, Jhpiego, Behavioural Scientists, Health Ministries and Concept Foundation Our aim is to develop, refine and evaluate an effective approach to managing refractory PPH. Despite concentrated efforts, PPH remains the leading cause why mothers die or suffer major complications during childbirth. Most women with PPH respond to initial treatments. However, a substantial number of women do not, and these are the women who suffer die or suffer major complications. There is an unmet need to define the optimal approach for managing refractory PPH. Furthermore, a management approach could achieve its intended goals only if it is widely accepted and used in everyday practice; thus a meaningful strategy for implementing this approach is necessary. We therefore propose the development, refinement and piloting of a refractory PPH management package and implementation strategy. Technical Summary Every six minutes a mother dies from postpartum haemorrhage (PPH) in low-resource countries, in the prime of her life and often leaving behind a young family. When a mother dies in childbirth, her infant has less than a 20% chance of surviving past the first month. PPH is the commonest reason maternal deaths worldwide. Effective first-line treatment can stop bleeding in most women diagnosed with PPH. However, those who continue to bleed despite first-line treatment are the women who suffer major morbidity and mortality. We have developed a provisional management package for refractory PPH, called the 'PPH ReAct' package. We wish to refine this management package, develop an implementation strategy for this, field-test these and finally pilot the approach in 5 health facilities in Kenya. Our objectives are: Objective 1: Refine the 'ReAct' refractory PPH management package through evidence synthesis, stakeholder engagement, and expert technical consultations. Objective 2: Develop an implementation strategy for refractory PPH management, through mixed-methods research, and a consensus-building co-design workshop. Objective 3: Field-test the refractory PPH management package and the implementation strategy in two health facilities in Kenya, through qualitative and quantitative methods. Objective 4: Pilot the refractory PPH management package and implementation strategy from objective 3 in five health facilities in Kenya, to evaluate its effects on process outcomes, as well as explore the feasibility of conducting a large scale implementation trial. |
| Type | Preventative Intervention - Behavioural risk modification |
| Current Stage Of Development | Early clinical assessment |
| Year Development Stage Completed | 2022 |
| Development Status | Under active development/distribution |
| Impact | None to date |
| Description | 12 lessons in Implementation Research: the E-MOTIVE case study - presentation to the Bill & Melinda Gates Foundation |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Third sector organisations |
| Results and Impact | 12 lessons in Implementation Research: the E-MOTIVE case study |
| Year(s) Of Engagement Activity | 2022,2023 |
| Description | Lancet PPH series meeting, Dubai, UAE |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Lancet PPH series meeting attended by 30 collaborators |
| Year(s) Of Engagement Activity | 2023 |
| Description | PPH collaborator's meeting, Cape Town, South Africa |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | PPH collaborator's meeting to discuss the E-MOTIVE trial |
| Year(s) Of Engagement Activity | 2022 |
| Description | WHO PPH summit, Dubai, UAE |
| Form Of Engagement Activity | A talk or presentation |
| Part Of Official Scheme? | No |
| Geographic Reach | International |
| Primary Audience | Professional Practitioners |
| Results and Impact | Presentation at a global WHO PPH summit, attended by 150 people which included industry leaders, leading academics, health ministers, policymakers, clinicians and midwives. |
| Year(s) Of Engagement Activity | 2023 |