Reflections on Uganda’s 10 Days of PPH Awareness Campaign 2024 

By Anitah Kusaasira and Hadijah Nakatudde, Young and Executive Midwife Leader Programme alumni 

This August, Uganda took a bold step forward in the fight against postpartum haemorrhage (PPH), by launching a 10-day national campaign that then extended throughout the entire month. The campaign, led by the Ministry of Health and supported by various stakeholders, aimed to shine a spotlight on the leading cause of maternal mortality both globally and in Uganda. 

The national campaign kicked off on 01 August 2024, with a commemorative event under the theme “Every Drop of Blood, Every Minute Counts.” This event, held in eastern Uganda marked the beginning of a month-long, concerted effort involving policy and decision makers, health workers, students, civil society organisations, professional associations and communities across the country. Their mission? To raise awareness about PPH and reduce its devastating impact on mothers across the country.  

Postpartum haemorrhage (PPH) is a serious and life-threatening condition in which a mother bleeds excessively after childbirth, and it remains the leading cause of maternal mortality in Uganda. Uganda has made substantial progress in reducing the maternal mortality ratio from 336 per 100,000 live births (UDHS, 2016) to 189 per 100,000 live births (UDHS, 2022). Despite this significant achievement, PPH, remains the leading cause of maternal deaths in the country, accounting for 1 in 3 maternal deaths according to the Maternal and Perinatal Death Surveillance and Response (MPDSR) report FY 2022/23. The World Health Organization (WHO) has published evidence-based recommendations for the prevention and treatment of PPH. Raising awareness of the burden of PPH among stakeholders, including the community, is critical. This campaign against PPH aims to empower and educate mothers, caregivers, and frontline health providers to prevent and effectively manage excessive bleeding, ultimately reducing maternal mortality rates. This condition can affect any mother, regardless of age, number of pregnancies, or mode of delivery, and it can be fatal within just two hours if not managed promptly.  

Midwives played a central role in this awareness campaign, both in organising the launch and participating in various awareness activities. They were involved in health education sessions, radio and TV presentations, and grand rounds in different regions. In addition, midwives continued to receive training on the E-MOTIVE first response bundle, an approach to managing PPH. 

The campaign also introduced healthcare providers to new technologies such as heat-stable carbetocin, tranexamic acid, uterine balloon tamponade, non-pneumatic anti-shock garments  and calibrated drapes for blood loss estimation – all tools that can make a real difference in PPH management. 

One of the most practical aspects of the campaign were the PPH simulations, grand rounds, and drills. These sessions were life-saving exercises that have now equipped our healthcare providers with the skills to better identify and manage PPH emergencies. 

The campaign didn’t just stop at hospitals and clinics. The campaign took to the airwaves with radio and TV talk shows, and to the streets with community outreach in markets, shopping centres, churches, mosques, and other public spaces. The campaign translated key messages to ensure that everyone, no matter their language, could understand the importance of PPH awareness.

Perhaps the most moving part of the campaign was the involvement of PPH survivors and their families, along with families of women who lost loved ones to PPH. Their stories, shared through speeches, photos, videos and songs at various events and through different communication channels, put a human face on the issue and reminded us all why this work is so important. 

The campaign included activities that involved men such as barazas, because maternal health is everyone’s responsibility. Integrating the messages about the importance early antenatal care and family planning, highlighting their role in preventing PPH. 

During the campaign, the Obstetric Haemorrhage Framework was disseminated to all Local Maternity and Neonatal Systems (LMNS). The framework guides in the implementation of strategically prioritised interventions to address obstetric haemorrhage and supports monitoring and evaluation to track progress in the implementation of planned activities. As part of the campaign, each LMNS undertook an in-depth analysis of their regional PPH statistics to identify specific causes and target their efforts more effectively. Midwives played a key role in these discussions, as they are the frontline health workers who support mothers during pregnancy and after childbirth. 

The success of the campaign lies not only in the activities carried out, but also in the lives touched and the knowledge shared. By raising awareness, the campaign empowered women, caregivers, and communities to recognise the early signs of PPH and act quickly, potentially saving lives. The campaign also highlighted the wider benefits of preventing PPH, such as reducing long-term complications such as infertility, reducing the burden on health systems, and ultimately ensuring that fewer mothers die in childbirth. 

The campaign was a collective effort, with diverse stakeholders joining forces. Key participants included the Minister and Permanent Secretary of Health, key Commissioners, and Members of Parliament. Members of the PPH sub-committee, including alumni of the Young and Executive Midwife Leaders programme Alumni, were actively involved in the launch and subsequent activities. Other stakeholders included professional associations, corporate organisations, cultural leaders, medical bureaus, religious institutions, rotary clubs, village health teams, medical and midwifery schools, the media, and the wider community.