Merck for Mothers’ approach to helping to reduce maternal mortality through investments to address the #1 driver of maternal deaths - postpartum hemorrhage

Merck for Mothers 1 is committed to supporting efforts to reduce maternal mortality globally. We collaborate across sectors — working with NGOs, professional associations, entrepreneurs, UN agencies, research institutions, governments and other companies – to address leading causes of maternal mortality and support countries in their efforts to strengthen health systems.

Our collaborative approach is undertaken with the goal of improving access to quality maternal health care, including access to quality medicines, and has been informed by consensus recommendations from the United Nations Commission on Life Saving Commodities for Women and Children 2 .

As the number one driver of maternal mortality, especially in low- and middle-income countries, Merck for Mothers has taken a comprehensive approach to addressing postpartum hemorrhage, or excessive bleeding after childbirth. Our efforts to address postpartum hemorrhage are informed by a health system strengthening approach and identifying possible solutions to challenges through human centered design 3,4,5,6 . Our aim is to identify, support and advance evidence-based practices for effectively, safely and sustainably introducing new solutions as part of routine standard of care and in accordance with guidelines.

We have invested in new innovations 7 and research including clinical trials 8,9,10 , studies to assess the quality of medicines 11 , research on uterotonic use at country level 12 and the translation of normative recommendations into policy 13 and practice in support of safe and appropriate adoption of solutions to prevent postpartum hemorrhage into health care delivery systems. Our collaborations have focused on:

  • Supporting the translation of normative guidelines into policy 14,15,16,17 and practice at a national level through the development of comprehensive resources, educational tools and job aids 18
  • Training and mentorship for health care workers and procurement managers to support safe and appropriate uterotonic use and improvements in supply chains 19
  • Assistance in exploring innovative financing for new maternal health medicines 20
  • Promoting respectful care through amplifying women’s voices 21 and supporting their choices through health literacy 22

Health inequities are often exacerbated by the inability to access quality-assured medicines. Merck for Mothers is investing in country-level implementation research and supporting processes to build capacity of local institutions to introduce innovations 23,24 and enhance decision making around the use of new medicines, including cost-effectiveness studies, and exploring the challenges and potential solutions to support safe introduction.

At a global level, we prioritize shared learning, supporting global conferences and workshops and disseminating evidence on the experiences of our collaborators - most recently through our support of a supplement in International Journal of Gynecology & Obstetrics on postpartum hemorrhage prevention and management 25 .

These investments in addressing postpartum hemorrhage are a key part of Merck for Mothers broader strategy to improve the quality of maternal health care 26 .

1 Merck for Mothers, known as MSD for Mothers outside the United States and Canada, is an initiative of Merck & Co., Inc., Rahway, NJ, U.S.A.

2 UN Commission on Life-Saving Commodities for Women and Children

3 Smiles for Mothers Program is using Human Centered-Design to co-create Public Health Innovations

4 Human-centered Design for Life: How Smiles for Mothers is Keeping Mothers Alive

5 Human Centered Design: PPH Reduction Initiative in Nigeria

6 Co-creating an improved response to postpartum hemorrhage

7 Profile of the Jada ® System: the vacuum-induced hemorrhage control device for treating abnormal postpartum uterine bleeding and postpartum hemorrhage

8 Heat-Stable Carbetocin versus Oxytocin to Prevent Hemorrhage after Vaginal Birth

9 Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data

10 The 'Birth day' prize, European Commission

11 Oxytocin Quality –Evidence for Action

12 A descriptive study of healthcare-providers’ experiences with the use and quality of oxytocin for the prevention of post-partum hemorrhage in Nigeria: A nation-wide survey

13 FIGO Generic Postpartum Haemorrhage Protocol and Care Pathways

14 Niger State updated their Essential Medicines List after a 3-day workshop

15 Kano State has validated their Essential Medicines List

16 National Guidelines on Quality Obstetrics and Perinatal Care, Ministry of Health in Kenya

17 Essential Maternal and Newborn Clinical Care Guidelines for Uganda, May 2022

18 An Opportunity to reduce Maternal Mortality in Nigeria

19 Federal Ministry of Health reviews Life Saving Skills Manuals with Stakeholders

20 Opportunities to reduce PPH: Making financing for the procurement of maternal health commodities sustainable

21 Another Listen, What Women Want- White Ribbon Alliance (page 43)

22 Raising community awareness for maternal health through Patient Literacy Materials

23 FIGO- Improving access to essential medicines to reduce postpartum haemorrhage (PPH) morbidity and mortality (IAP)

24 Merck for Mothers website- map of grantees and collaborators; select Global to find Concept Foundation; select Kenya to find Jhpiego

25 Improving access to essential medicines to reduce postpartum hemorrhage morbidity and mortality

26 Merck for Mothers website