By Jostas Mwebembezi | Executive Director
Rolling Out New and Lesser Used Medicine for Postpartum Hemorrhage in Uganda,
a Case Study of Rwenzori Region, September 2023–May 2024.
Authors: Lawrence Tumusiime¹’²* J.Mwebembezi¹, S.Atuhairwe¹
Institutional affiliations:
¹Rwenzori Centre for Research Advocacy-Uganda, ²Uganda Public Health Fellowship
Program
*Correspondence: Lawrence Tumusiime, +256779712458, ltumusiime@uniph.go.ug
Background: In 2028, WHO recommended the use of heat-stable carbetocin (HSC)
and tranexamic acid (TXA) for Postpartum Hemorrhage (PPH) prevention and
management, respectively. In Uganda, PPH contributes 34% of the maternal deaths.
Despite the high PPH prevalence in Uganda, the use of these commodities is very
minimal. We rolled out HSC and TXA in Rwenzori region to increase access to life-
saving medicines for PPH, to reduce maternal morbidity and mortality rates.
Description: The project was implemented from September 2023–May 2024. The
implementation took place in 9 districts and one city of the Rwenzori region, which
included Bundibugyo, Bunyangabu, Fort Portal City, Kabarole, Kamwenge, Kasese,
Kitagwenda, Kyegegwa, Kyenjojo, and Ntoroko, with activities implemented at the
regional, district, and facility levels. We conducted a regional inception meeting with
relevant stakeholders, trained regional trainers to re-orient participants with the
basics on PPH, HSC, and TXA. Conducted facility-based mentorship on supply chain
strengthening, PPH, HSC, and TXA, and conducted joint supportive supervision.
Lessions learnt: Conducted a one-day inception meeting, attended by 52
stakeholders from districts and Ministry of Health. The stakeholders were taken
through their respective roles in the project, and they pledged their commitment to
support the project. Conducted a 5-days training of 50 regional trainers with 5
participants from each district. Conducted a 2-day facility based mentorship at each
of the 136 health facilities, and mentored 1370 health workers. Conducted targeted
supportive supervision covering 20 health facilities.684,300 women received PPH
prevention and care services, and 3780 women received HSC or HSC and TXA for PPH
prevention and treatment.
Conclusion: The project was successfully implemented, with the success attributed
to the great engagement and involvement of relevant stakeholders at all levels. We
recommend scale-up of HSC and TXA implementation nationwide, and continued
training for healthcare providers.
Keywords: Heat, Stable, Carbetocin, Postpartum, Haemorrhage, Tranexamic acid
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