Step 5: Increase Awareness Among Women and Their Families

Mobilizing families and communities increases demand for services, a vital step in improving care for mothers and newborns. When women and their caregivers understand potential dangers and are prepared, it leads to better outcomes.

Identify women’s, families’ and communities’ understanding of the problem and barriers to action: In countries where PPH is a major killer, especially at home births, the problem is often well-known, but recognizing when bleeding is too much and accessing life-saving care are barriers. Often barriers to PPH prevention and management are larger economic, geographical or cultural issues. National behavior change communication or community mobilization strategies will likely address most barriers, but those specific to PPH prevention seeking behaviors need to be explored and integrated.

Develop tools, materials and activities to address barriers and mobilize communities: Communication messages, materials and activities focused on behavior change for PPH prevention and management can be developed and integrated into existing maternal and newborn health campaigns, reaching pregnant women and their families.

    • In addition, in most countries where misoprostol was distributed for PPH prevention at home births, behavior change communication activities are planned to help name or brand and position the packet of tablets (such as “Immediate Response to Hemorrhage [perdarahan atasi segara]” in Indonesia; “Tablet against PPH [Golee Zed-e- Khoon Reyzee Bad Az Wiladat]” in Afghanistan; and “Mother’s Protection Tablet [matri suraksha chakki]” in Nepal).

Link communities and facilities to improve access and demand for care: To ensure the continuum of care for PPH prevention and management, referral systems need to be in place to ensure women can get to life-saving care when needed. Linking communities to nearby providers and facilities helps improve communication, care-seeking and referrals.

Mobilize CHWs and communities for PPH: Many countries have found CHWs invaluable in promoting birth preparedness and complication readiness—some expanding their role to deliver services and commodities, make referrals and monitor outcomes. They can also assist in mobilizing communities for birth preparedness/complication readiness (such as the successful Desa Siaga campaign in Indonesia) to arrange transport, funds and blood donors in emergencies.

Program Pitfalls and Lessons Learned: Behavior Change Communication

    • Because communities often do not recognize maternal complications as a problem, conducting formative research helps to determine communities’ understanding of the major killers of women and newborns, and enlisting leaders and influential people helps to develop solutions.

    • Targeting behaviors, including key essential newborn care practices and care-seeking, can achieve significant improvements.

 

Community Education Fact Sheet for Preventing PPH
2009 | POPPHI | 2p
This 2-page fact sheet includes basic information for families and communities on preventing PPH including use of a skilled birth attendant, preparing for birth, recognizing heavy bleeding, and taking action.
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Misoprostol Distribution during Antenatal Care Visits, Preliminary Report, Tanzania
2009 | VSI | 19p
This report presents preliminary results of the joint operations research project to assess the feasibility, program effectiveness, safety, and acceptability of misoprostol distribution via ANC visits to prevent PPH at home births.  Overall, these preliminary results are positive.  In terms of feasibility, ANC providers have been successful in recruiting women to the project during ANC visits, and we are seeing more women enroll in the project than expected.  In addition, of those who are eligible to receive misoprostol, virtually all women are given the drug during an A
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Prevention and Treatment of PPH at the Community Level: A Guide for Policy Makers, Health Care Providers, Donors, Community Leaders and Program Managers
2008 | POPPHI | 18p
This document examines evidence related to the prevention and treatment of PPH, or one or more of its components, at the community level and when a skilled or nonskilled birth attendant is assisting the birth. The purpose of the document is to guide policy makers, health practitioners, donors, community leaders, and program managers who are developing community-based interventions to address the need to increase capacities at the household and community level to improve MNH and to respond to obstetric and MNH emergencies.
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Prevention of Postpartum Hemorrhage: Learning Resource Package for Community Health Workers
2005 | Government of Nepal Ministry of Health and Population
This training package was developed for training community health workers on PPH prevention at home births using misoprostol. Developed in Nepal,this 3-day course is designed to prepare female community health volunteers (FCHVs) to give information to pregnant women, their families, and their community members on the causes and prevention of excessive bleeding after childbirth.
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