International Journal of MCH and AIDS最新文献

{"title":"Improving HIV Prevention for Key Populations in Nigeria: Insights on Access, Barriers, Stigma, and Service Utilization.","authors":"Godwin Omokhagbo Emmanuel, Olaniyi Felix Sanni, Abang Roger, Paul Umoh, Ochonye Bartholomew Boniface, Amechi Paul, Ismaeel Mohammed Yahaya, Agie Muhmmad Auwal","doi":"10.25259/IJMA_49_2024","DOIUrl":"10.25259/IJMA_49_2024","url":null,"abstract":"<p><strong>Background and objective: </strong>Human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) remains a significant public health challenge globally, with key populations (KPs) such as female sex workers (FSWs), men who have sex with men (MSM), and people who inject drugs (PWIDs) being disproportionately affected. Despite the availability of various HIV prevention services, including pre-exposure prophylaxis (PrEP) and community-based antiretroviral therapy (ART), the willingness of KPs to access these services remains a critical concern. This study aims to assess the prevalence of HIV and the willingness to access HIV preventive services among KPs in three selected local government areas (LGAs) in Nigeria.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 2023 across three LGAs, Gwale, Fagge, and Tarauni, in Kano State, Nigeria, using a snowball sampling technique. A total of 1,320 participants, recruited from brothels and nightclubs, were tested for HIV using self-test kits. Willingness to access HIV services was assessed using a structured questionnaire. Data were analyzed using descriptive statistics and binary logistic regression.</p><p><strong>Results: </strong>The overall HIV prevalence among KPs was 10.8%. MSM and PWIDs exhibited higher HIV prevalence rates compared to FSWs. Willingness to access HIV preventive services was recorded at 57.7%, with significant influences from geographical location and sexual practices. Participants from Tarauni were more willing to access services, and those engaging in vaginal sex were more likely to seek preventive services. HIV self-testing had a high uptake of 95.9%, while PrEP uptake was 68.0%. Major barriers included stigma, lack of comprehensive services, and limited knowledge of service providers.</p><p><strong>Conclusion and global health implications: </strong>This study highlights the critical need for targeted interventions addressing the specific barriers faced by KPs in these regions. Enhancing service accessibility and addressing stigma is essential for reducing HIV transmission and achieving epidemic control in Nigeria by 2030.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"14 ","pages":"e005"},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing WHO Differentiated Service Delivery Model for Pregnant and Breastfeeding Women and Infants Living with HIV: Insights from Kenyan Healthcare Providers.","authors":"John Humphrey, James G Carlucci, Esther Karen Wanjama, Violet Naanyu, Lindah Muli, Joy Marsha Alera, Edwin Were, Alan McGuire, Winstone Nyandiko, Gregory Zimet, Julia Jerono Songok, Kara Wools-Kaloustian","doi":"10.25259/IJMA_43_2024","DOIUrl":"10.25259/IJMA_43_2024","url":null,"abstract":"","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"14 ","pages":"e004"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV Testing, Household and Reproductive Health Decision-Making: The Role of Women Autonomy in a Nationally Representative Study in Cambodia.","authors":"Wah Wah Myint, Aishatu Yusuf, Angela Nguyen, Elfreda Samman","doi":"10.25259/IJMA_36_2024","DOIUrl":"10.25259/IJMA_36_2024","url":null,"abstract":"<p><strong>Background and objective: </strong>Women's autonomy plays a critical role in decision-making of health service use. This study aims to evaluate the relationship between Human Immunodeficiency Virus (HIV) testing and decision-making autonomy among Cambodian women aged 15-49.</p><p><strong>Methods: </strong>We used data from the 2021-2022 Cambodia Demographic and Health Survey (DHS) and our sample consisted of currently married/cohabiting women aged 15-49 (<i>N</i> = 13,755). The outcome variable was \"ever been tested for HIV.\" Covariates were household decision-making and reproductive health decision-making scores, socio-demographic characteristics (age, place of residency, education, wealth quintiles, and employment status), and HIV knowledge (HIV self-test kits, drugs to prevent HIV in babies during pregnancy, antiretroviral [ARV] drugs, and pre-exposure prophylaxis).</p><p><strong>Results: </strong>Sixty-one percent of studied women reported ever being tested for HIV. The logistic regression results revealed that women with a higher household decision-making score (aOR = 2.09, <i>p</i> < 0.001), reproductive health decision-making score (aOR = 1.72, <i>p</i> < 0.001), from 25 to 29 age groups (aOR = 2.21, <i>p</i> < 0.001), with a higher education (aOR = 1.96, <i>p</i> = 0.001), from the richest groups (aOR = 1.73, <i>p</i> < 0.001), had knowledge of HIV test kits but never get tested (aOR = 1.38, <i>p</i> = 0.035), heard of drugs to avoid HIV transmission to babies during pregnancy (aOR = 1.21, <i>p</i> < 0.001), and heard of ARV drugs (aOR = 1.28, <i>p</i> < 0.001) were more likely to get tested for HIV than their counterparts. Women living in rural areas (aOR = 0.56, <i>p</i> < 0.001) and those who had discriminatory attitudes (aOR = 0.76, <i>p</i> = < 0.001) were less likely to get HIV tests than those in urban areas and those without discrimination.</p><p><strong>Conclusion and global health implications: </strong>Findings revealed that greater autonomy is important for health care use, particularly HIV testing for women in Cambodia.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"14 ","pages":"e001"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Health Divide: Opportunities for Reducing Health Disparities and Promoting Equitable Care for Maternal and Child Health Populations.","authors":"Mehrete Girmay","doi":"10.25259/IJMA_41_2024","DOIUrl":"https://doi.org/10.25259/IJMA_41_2024","url":null,"abstract":"<p><p>The integration of telehealth into maternal and child health (MCH) care presents an opportunity to enhance health equity, offering solutions to bridge gaps in access and quality of care. This paper explores the impact and reach of telehealth services on MCH, emphasizing its potential to address disparities in healthcare access, particularly for underserved and marginalized populations. Telehealth facilitates improved access to care by reducing geographical barriers, offering convenient and flexible consultation options, and providing cost-effective solutions for low-income families. This paper also crystallizes the importance of telehealth services on the continuity of care through consistent remote monitoring, which is crucial for managing chronic conditions and ensuring timely interventions during pregnancy and early childhood. However, the effective implementation of telehealth in MCH also faces significant challenges, including the digital divide, which limits technology access and digital literacy among vulnerable populations. Enhancing digital literacy is essential for empowering individuals to navigate telehealth services effectively and to make informed health decisions. To advance health equity, it is crucial to address these challenges by expanding technology access, improving digital literacy, and developing supportive policies that ensure comprehensive telehealth coverage while considering the Social Determinants of Health (SDoH). This paper explores the importance of leveraging telehealth and other timely interventions to improve MCH equity and justice, including the provision of technological resources and comprehensive policy frameworks. By addressing these factors, telehealth can significantly contribute to reducing health disparities and promoting equitable care for all maternal and child populations.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"13 ","pages":"e026"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapted Counseling Care Model for Management of Female Sexual Dysfunction Among Women Living With and Without HIV.","authors":"Fatima M Damagum, Zainab D Ahmed, Rabiu I Jalo, Hamisu M Salihu, C William Wester, Muktar H Aliyu","doi":"10.25259/IJMA_37_2024","DOIUrl":"https://doi.org/10.25259/IJMA_37_2024","url":null,"abstract":"<p><strong>Background and objective: </strong>Sexual health research among women living with human immunodeficiency virus (HIV) has focused mainly on sexual practices and risk behaviors, with little consideration for treating sexual dysfunction and improving sexual satisfaction. The aim of this pilot study was to assess the effectiveness of an adaptive counseling care model in the management of female sexual dysfunction (FSD) among women living with HIV and without HIV in northern Nigeria.</p><p><strong>Methods: </strong>This was a prospective cohort study of 200 women with HIV and a matched comparison arm of 200 women without HIV. Sexual function was assessed using the Female Sexual Function Index (FSFI), with a score ≤ 26.55 indicating FSD. We counseled women with FSD using the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model and evaluated the effectiveness of the model by comparing mean differences in baseline and six weeks post-intervention FSFI scores.</p><p><strong>Results: </strong>The overall prevalence of FSD was 96.8%, with no difference between HIV-positive and HIV-negative participants (<i>p</i> = 0.398). Based on the six domains of the FSFI, the most common reported dysfunctions were sexual pain (21.7%), sexual desire disorder (17.6%), orgasm disorder (17.6%), lubrication disorder (17.2%), sexual arousal (16.9%), and poor sexual satisfaction (9.0%). The overall mean FSFI score (±standard deviation, SD) for those with FSD, in both groups (<i>n</i> = 387) prior to the counseling intervention was 16.05±10.65 (HIV-positive: 18.58±8.46; HIV-negative: 13.98±10.85). At the end of the intervention, the overall mean FSFI score in both groups increased to 23.58±16.53 (HIV-positive: 21.37±11.24; HIV-negative: 16.72±13.81) (<i>p</i> < 0.05 in all cases).</p><p><strong>Conclusion and global health implications: </strong>FSD is very common among women in Northern Nigeria, irrespective of HIV status. An adapted counseling care model improved sexual function in both HIV-positive and HIV-negative women. The PLISSIT model can guide healthcare providers to initiate and navigate sexual health discussions with women in this setting.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"13 ","pages":"e025"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of an Intervention on Caregivers' Awareness and Completion of Continuum of Care Among Pregnant Women.","authors":"May Soe Aung, Myint Moh Soe, Hla Hla Win, Kyaw Swa Mya","doi":"10.25259/IJMA_22_2024","DOIUrl":"https://doi.org/10.25259/IJMA_22_2024","url":null,"abstract":"<p><strong>Background and objective: </strong>The continuum of care (CoC) is an important approach that should be prioritized for improving maternal health. The World Health Organization recommends working with individuals, families, and communities to ensure continuous care throughout pregnancy, childbirth, and the postpartum period. The purpose of this study was to assess the impact of an intervention on the awareness of the CoC among main caregivers and the completion of CoC among pregnant women.</p><p><strong>Methods: </strong>During the COVID-19 pandemic, a community-based quasi-experimental study was conducted in two townships of the Yangon Region, including 200 pairs of pregnant women and their caregivers. The intervention focused on providing health education sessions and distributing pamphlets to caregivers in the intervention group. The study aimed to assess the awareness of main caregivers about CoC and completion of CoC among pregnant women. A key predictor variable for evaluating the outcome was receiving an intervention package by the main caregivers in the intervention. The analysis used logistic regression, including the propensity score model, and was conducted using STATA vs 15.1.</p><p><strong>Results: </strong>The final analysis included 193 pairs. Most main caregivers were husbands: 47 were husbands in the intervention and 59 in the control group, while 24 mothers were included in both groups. The awareness of CoC for maternal health among main caregivers from the intervention group was 9.97 times higher than those from the control group (AOR = 9.97, 95% CI: 5.12 to 19.43, p < 0.001). The completion of CoC among women from the intervention group was 2.17 times higher than those from the controls (AOR = 2.17, 95% CI 1.08 to 4.37, p < 0.05). The awareness of main caregivers was found to be a significant predictor for completion of CoC.</p><p><strong>Conclusion and global health implications: </strong>Health education intervention for main caregivers could improve CoC completion among pregnant women. It provided baseline information for further interventions at the family level for improving CoC among pregnant women in the future.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"13 ","pages":"e024"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involvement of Male Partners in Sustaining Interventions for Preventing Mother-to-Child Transmission of HIV Among Women with HIV.","authors":"Fulufhedzani C Malindi, Maria S Maputle","doi":"10.25259/IJMA_645","DOIUrl":"https://doi.org/10.25259/IJMA_645","url":null,"abstract":"<p><strong>Background and objective: </strong>Although male partners are eager to support the implementation of prevention of mother-to-child transmission (PMTCT) of HIV programs, several obstacles prevent them from participating. The purpose of this study was to explore the support of male partners of HIV-positive women in sustaining the implementation of PMTCT interventions.</p><p><strong>Methods: </strong>This study adopted a qualitative approach. The case study research design was used to generate an in-depth understanding of the factors that hinder male participation in PMTCT interventions. Non-probability purposive sampling was used to 20 sample participants. Data was collected from two focus group discussions and analyzed using open coding. Trustworthiness was achieved by credibility, transferability, and confirmability. Adherence to ethical principles was upheld.</p><p><strong>Results: </strong>Findings revealed two themes, perceived practices that hinder the provision of support and perceived support provided to sustain PMTCT intervention during childbirth. Sustaining PMTCT interventions included how the male partner adheres to interventions that prevent the transmission of the virus, like consistent condom use, especially during breastfeeding, support in exclusive breastfeeding, adherence to ART, and limiting the use of cultural practices.</p><p><strong>Conclusion and global health implications: </strong>The involvement of males in the interventions of PMTCT has been found to improve the sustainability of eliminating transmission of the virus to the baby. All clinics were recommended to be men user-friendly to encourage men to accompany their partners. Men are to be actively involved during decision-making and physical examination, where possible. Workshops and information-sharing sessions for men forums and community members on PMTCT interventions to be conducted.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"13 ","pages":"e023"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering Midwives in Humanitarian Settings: Integrating Heat-Stable Carbetocin and Tranexamic Acid into Postpartum Hemorrhage Training.","authors":"Alice Rosmini, Kidza Mugerwa, Awatta Walter Ochan, Sarah Muwanguzi, Jemelia Sake, Richard Mwesigwa, Okpwoku Sukere, Catrin Schulte-Hillen, Nguyen Toan Tran","doi":"10.25259/IJMA_10_2023","DOIUrl":"10.25259/IJMA_10_2023","url":null,"abstract":"<p><strong>Background and objective: </strong>Maternal mortality remains extremely high in fragile settings, with hemorrhage as the leading cause. This study describes a new model for more effective training on postpartum hemorrhage (PPH) prevention and treatment.</p><p><strong>Methods: </strong>Using a low-dose (of information) and high-frequency (of repetitions) approach (LDHF), the strategy comprised an introductory webinar, self-paced study, 2-day in-person workshops, cascade training, continuous facility-based skills drills, and a WhatsApp community of practice and supervision (CoP). Innovations consisted of the practical, midwifery-centered, and short-duration training, and the integration of tranexamic acid (TXA) and heat-stable carbetocin (HSC) into existing modules from the \"Bleeding-After-Birth-Complete\" toolkit. Effects were assessed through mixed-methods evaluation. Confidentiality and \"do-not-harm\" principles were respected.</p><p><strong>Results: </strong>Nine training sessions were conducted in South Sudan and Uganda combined, engaging 126 participants. Average knowledge increases of 21% in South Sudan and 18% in Uganda were recorded. Feedback also indicated changes in practices and attitudes: enhanced competency, teamwork, clinical protocols adherence, appreciation for midwife-led practical sessions, the LDHF method, and continuous support through the WhatsApp CoP. In post-workshop action plans, facility teams outlined steps to apply acquired knowledge and skills. These included training colleagues, establishing quality improvement projects, conducting skill drills, ensuring job aid visibility, and systematically reporting on PPH in the data collection templates of the facilities.</p><p><strong>Conclusion and global health implications: </strong>This case study highlights the value of a practical, LDHF refresher training strategy. This strategy bolstered providers' skills, knowledge, and confidence in using HSC and TXA for PPH prevention and treatment. Findings can guide future training in similar fragile, low-resource, and humanitarian settings. Strengthening midwifery leadership, fostering interdisciplinary collaboration, and using the LDHF training approach can contribute to resilient health systems and taskforce, aligning with global efforts to reduce maternal mortality.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"13 Suppl 1","pages":"S72-S80"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, Acceptability, and Appropriate Use of Novel and Lesser-Used Medicines for Prevention and Treatment of Postpartum Hemorrhage: Evidence from Implementation Research.","authors":"Sara Rushwan, Tesfaye Tufa, Metin Gülmezoglu","doi":"10.25259/IJMA_17_2023","DOIUrl":"10.25259/IJMA_17_2023","url":null,"abstract":"<p><p>Maternal mortality remains one of the primary global health challenges of the 21st century, despite major medical advances in the field. Although solutions are available, inequities determine where mothers die, with the majority of maternal deaths occurring in low- and middle-income countries (LMICs). More than one-third of maternal deaths are related to obstetric hemorrhage and most commonly postpartum hemorrhage (PPH). Effective, quality-assured uterotonics significantly reduce PPH-related morbidity and mortality. Updated World Health Organization (WHO) recommendations on uterotonics used for PPH prevention include the addition of heat-stable carbetocin (HSC) to the suite of prophylactic uterotonic agents as well as the use of tranexamic acid (TXA) for PPH treatment. Both medicines are promising interventions in obstetric care. However, the introduction of these medicines faces numerous challenges to end-user access, such as decentralized procurement, time-consuming policy updates, market access barriers, lack of demand for quality-assured products, and inadequate systematic training and information provision, impeding access in many LMICs. Assessing the feasibility and acceptability of implementing these medicines in different resource settings can help bridge the gap between research and development to policy and practice, in an effort to reduce the significant health inequities facing women accessing the public health sector for quality care during labor and delivery. In this Special Collection, we explore the findings from mixed-methods implementation research studies in nine LMICs which support the acceptability and feasibility of HSC and TXA administration by healthcare providers, generating evidence to help inform the introduction and scale-up of these new and lesser-utilized PPH medicines.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"13 Suppl 1","pages":"S4-S8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction of Heat-Stable Carbetocin through a Public-Private Partnership Model in India: A Retrospective Study to Determine Feasibility and Its Optimal Use in Public Health Settings.","authors":"Vaishali Alwadhi, Archana Mishra, Anil Nagendra, Devina Bajpayee, Naresh Chandra Joshi, Sachin Gupta, Harish Kumar","doi":"10.25259/IJMA_11_2023","DOIUrl":"10.25259/IJMA_11_2023","url":null,"abstract":"<p><strong>Background and objective: </strong>The optimal use of oxytocin for preventing postpartum hemorrhage (PPH) faces challenges in many low-middle income countries (LMICs) owing to its storage and transportation prerequisites. We demonstrated Heat-Stable Carbetocin (HSC) for PPH prevention through an innovative Public-Private Partnership (PPP) model in 15 public health facilities of the Dewas District of Madhya Pradesh (MP) state in India. This study evaluates the feasibility and appropriate utilization of HSC in public health settings.</p><p><strong>Methods: </strong>We analyzed facility-level data collected between August 2022 and July 2023 from selected 15 health facilities, where HSC was introduced. Prior to the introduction of HSC, all healthcare providers received training on Active Management of the Third Stage of Labor (AMTSL), use of HSC, and recording and reporting procedures. The supply of HSC in health facilities was ensured, and a robust mechanism was set up to monitor the progress.</p><p><strong>Results: </strong>A total of 18,497 women were admitted for delivery in the 15 selected facilities. Uterotonic administration within one minute of delivery was almost universal (99.9%). No instance was recorded of using HSC either for induction of labor or management of PPH. In 636 cases (3.43%), HSC was not given for PPH prevention. Pearson's chi-square test was conducted to assess the relationship between HSC usage and the health facility's level. The HSC use was significantly higher in First Referral Unit (FRU) facilities compared to non-FRUs (p < 0.001). Moreover, the administration of HSC within one minute of delivery was also more prevalent in FRU facilities compared to non-FRUs (p < 0.001). The PPH incidence and case referral rates noted in this study were 0.7% and 16.7%, respectively, with no reported adverse drug events or deaths.</p><p><strong>Conclusion and global health implications: </strong>Our study suggests the safe and appropriate use of HSC within India's public health system.</p>","PeriodicalId":30480,"journal":{"name":"International Journal of MCH and AIDS","volume":"13 Suppl 1","pages":"S81-S88"},"PeriodicalIF":0.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}