Interventions for Impact in Essential Obstetric and Newborn Care Asia Regional Meeting | 3–6 May 2012 | Dhaka, Bangladesh Meeting Report Editors Sheena Currie Joseph de Graft-Johnson Rae Galloway Carmen Sheehan Jeffrey Smith Table of Contents Abbreviations and Acronyms ............................................................................................................ vii Acknowledgments .............................................................................................................................. ix Executive Summary ............................................................................................................................. x Scope and Purpose ......................................................................................................................... x Overview ........................................................................................................................................... x Context ............................................................................................................................................ xi Take-Home Messages ....................................................................................................................xii Introduction ......................................................................................................................................... 1 Special Feature: Online Engagement ................................................................................................. 3 Summary .......................................................................................................................................... 3 Different Media Used ...................................................................................................................... 3 Reach and Impact ........................................................................................................................... 5 Costs and Savings ........................................................................................................................... 6 Lessons Learned ............................................................................................................................. 7 Opening Day, 3 May 2012 .................................................................................................................. 8 Special Technical Sessions ............................................................................................................. 8 Opening Ceremony .......................................................................................................................... 8 Day 1, 4 May 2012 .......................................................................................................................... 13 Plenaries ....................................................................................................................................... 13 Plenary 1: Improvements in Maternal Health: The Changing Situation in MNH in Asia .......... 13 P-1.1: Maternal Mortality, 1990‒2011: Asia and Pacific Stories of Tremendous Successes ........... 13 P-1.2: Afghanistan’s Experience in Reducing Maternal Mortality ........................................................ 13 P-1.3: Reducing Maternal Mortality in Nepal ........................................................................................ 14 P-1.4: Cambodia’s Successful Efforts to Reduce Maternal Mortality and Its Challenges .................. 14 P-1.5: Key Socioeconomic Determinants of Maternal Health .............................................................. 15 Plenary 2: Global Evidence and Guidance for PPH Prevention & Treatment .......................... 16 P-2.1: 2012 WHO Guidelines for Prevention and Treatment of PPH ................................................... 16 P-2.2: Active Management of the Third Stage of Labor without Controlled Cord Traction: A Randomized Non-Inferiority Controlled Trial (HRP Trial A65554) ........................................................ 16 P-2.3: The Evidence for Use of Misoprostol in the Prevention and Treatment of Postpartum Hemorrhage ............................................................................................................................................ 17 P-2.4: Prevention and Management Strategies of Postpartum Hemorrhage at Different Levels of Health System in Bangladesh ................................................................................................................ 18 Plenary 3: Overcoming Barriers and Measuring Success—Implementing PPH Prevention and Management Programs ............................................................................................................... 19 P-3.1: Monitoring Program Performance in Maternal and Newborn Health) ...................................... 19 P-3.2: Community Level Use of Misoprostol for PPH Prevention: What Works and What Is Next? ... 20 P-3.3: Bangladesh Program for the Prevention of Postpartum Hemorrhage: Implementation Experiences ............................................................................................................................................. 21 P-3.4: Nepal: A Pioneer in Community-Based Distribution of Misoprostol for Prevention of PPH at Homebirth ............................................................................................................................................... 21 Interventions for Impact in Essential Obstetric and Newborn Care iii Plenary 4: Drugs and Commodities ............................................................................................ 22 P-4.1: Assessing the Potency of Oxytocin and Methylergometrine in Four Districts of India ............. 22 P-4.2: Quality of Misoprostol Products .................................................................................................. 23 P-4.3: Quality of Oxytocin Injections: A Case Study in Indonesia ......................................................... 23 P-4.4: Pharmaceutical Management for Maternal Health: Assuring Access to Quality Medicines and Supplies ................................................................................................................................................... 24 Optional Evening Satellites (May 4) ............................................................................................. 25 OS-1.1: Story of Bangladesh Maternal Mortality Reduction ..................................................... 25 OS-1.2: Exploring Use of Uterotonic Substances at or around Birth in Two States in India ... 26 OS 1.3: Training on PPH Prevention: “Bleeding After Birth” (BAB) ........................................... 27 OS-1.4: Improving Newborn Survival: Role of Chlorhexidine Application to the Umbilical Stump ........................................................................................................................................... 28 OS-1.5: Improving Maternal Health with Commodities: How the UN Commission on Life-Saving Commodities for Women and Children Can Transform the Agenda ..................... 28 OS-1.6: Respectful Care at Birth: Research and Advocacy ....................................................... 30 OS-1.7: Selecting a Rational Mix of Uterotonic Drugs for Presentation and Treatment of PPH ......................................................................................................................... 32 Day 2, 5 May 2012 .......................................................................................................................... 34 Plenaries ....................................................................................................................................... 34 Plenary 5: Midwifery for Reduction of Maternal and Newborn Mortality ................................. 34 P-5.1a: State of the World’s Midwifery Report ...................................................................................... 34 P-5.1b: ICM/UNFPA Investing in Midwives Program: Key Midwifery Achievements in Asia ............... 34 P-5.2: Supporting the Health System by Strengthening Midwifery in Afghanistan ............................. 35 P-5.3: ICM Video for 2012 International Day of the Midwife ............................................................... 36 Plenary 6: Evidence for Prevention and Detection of Pre-Eclampsia/Eclampsia (PE/E) ........ 36 P-6.1: 2011 WHO Guidelines for Prevention and Treatment of Pre-Eclampsia and Eclampsia ........ 36 P-6.2: Use of Calcium and Vitamin D for Prevention of Pre-Eclampsia/Eclampsia ............................ 37 P-6.3: Quality of Care for Screening and Management of Pre-Eclampsia/Eclampsia: Review of Data from Six Countries .................................................................................................................................. 37 P-6.4: Screening and Early Detection of Pre-Eclampsia ....................................................................... 38 Plenary 7: Evidence for Decisions in PE/E Management .......................................................... 39 P-7.1: Choice of Anticonvulsant for Prevention and Management of Eclamptic Seizures ................. 39 P-7.2: Anti-Hypertensive Therapy for Pre-Eclampsia/Eclampsia Management .................................. 39 P-7.3: Induction of Labor Recommendations ....................................................................................... 40 P-7.4: Management Strategies at Different Levels of