Programmatic Implications
As evidenced by this review, several interventions exist to both prevent and treat PPH at the community-level,
ranging from medical interventions to more distal community-readiness, education, and preventive measures.
When choosing strategies to implement at the community level, it is important to assess existing maternal and
primary care services, strategies, programs and resources, and to integrate PPH prevention and treatment
interventions into those efforts.
However, introducing several interventions to prevent and treat PPH at the same time in a community has its own
implications. There is potential for community-members to confuse messages (e.g. correct regimen for misoprostol
for prevention vs. treatment of PPH). With several interventions, community members may not be aware of the
most effective intervention, and inadvertently cause delays (e.g. wait for an intervention to work rather than send
to a referral). Therefore, interventions introduced at the community-level must be chosen and implemented so that
the most effective interventions are highlighted and emphasized. For example, misoprostol for PPH prevention and
treatment is the most effective uterotonic at the community level, and should be bolstered by a strong referral
network and knowledge of when it is appropriate to refer.