Breaking the Cycle of Maternal Mortality: Nigeria’s Quest for a Solution
Every day, countless mothers in Nigeria lose their lives to postpartum haemorrhage (PPH), a devastating reality that accounts for 22% of the country’s maternal deaths. With Nigeria responsible for 28.5% of global maternal deaths, the need for effective solutions has never been more pressing. Recently, a webinar hosted by Smiles for Mothers, in collaboration with Nigeria’s Ministry of Health and Social Welfare and Ferring Pharmaceuticals, brought leading experts together to discuss the "Best Practice on the Use of Heat-Stable Carbetocin (HSC) and Other Uterotonics for Prevention of Postpartum Haemorrhage (PPH) in Nigeria."
The current gold standard for PPH prevention, oxytocin, requires refrigeration, which poses a significant challenge in low-resource settings where consistent power supply is a luxury. Up to 40% of primary healthcare centres in Nigeria lack access to electricity, rendering oxytocin ineffective due to improper storage. In contrast, Heat-Stable Carbetocin (HSC) remains stable at temperatures up to 30°C, making it an attractive alternative. According to Dr. Vishal Shah, Director at Ferring Pharmaceuticals, "Heat-Stable Carbetocin represents a critical shift in how we approach PPH prevention. It reduces the burden on healthcare providers while ensuring consistent effectiveness in resource-limited settings."
The CHAMPION trial, one of the largest studies on uterotonics, confirmed that HSC is as effective as oxytocin in preventing PPH. The trial demonstrated that HSC led to comparable reductions in blood loss while offering the added benefit of temperature stability. With HSC lasting 4 to 10 times longer than oxytocin, it enables prolonged uterine contraction with a single injection, reducing the need for multiple doses and making it a more cost-effective option.
To scale up the use of HSC, the Nigerian government has launched the Maternal Mortality Reduction Innovation Initiative (MAMII) strategy, which aims to reduce maternal mortality by 30% in 172 priority Local Government Areas (LGAs). The strategy includes training 120,000 frontline healthcare workers, improving primary healthcare centre functionality, and deploying maternal and neonatal health innovations. To ensure the success of HSC, the government must strengthen procurement and supply chain systems, expand primary healthcare facility capacity, and provide training and capacity building for healthcare providers.
As Naanma Kangkum, Manager at Solina Centre for International Development and Research, noted, "Poor-quality uterotonics cost Nigeria an estimated $73 million annually due to treatment failures and increased healthcare expenses." By adopting best practices in HSC utilization and aligning it with the MAMII strategy, stakeholders can work together to significantly reduce the burden of PPH and save the lives of countless mothers in Nigeria. With a public-access priced version of HSC Carbetocin now available in the Nigerian market, the country is one step closer to breaking the cycle of maternal mortality and ensuring a brighter future for its mothers.
