Utilizing CLA approach to design and implement an innovative PPH prevention model in India

The use of oxytocin to prevent bleeding after birth, i.e., postpartum hemorrhage (PPH), faces challenges owing to a lack of capacity for AMTSL implementation and suspect quality of the drug. There is sufficient evidence supporting the use of the newer drug carbetocin; however, ensuring its appropriate use in the public health system of India was a challenge. Recognizing the maternal health challenge exacerbated by suboptimal oxytocin efficacy, the CLA approach helped in designing and implementing a PPH prevention model in public health facilities of Madhya Pradesh using catalytic mission resources. The foundation lies in rigorous evidence review and strategic collaboration. Comprehensive desk reviews and partnerships with stakeholders like state government, Ferring Pharmaceuticals, and IIHMR ensured informed decision-making and logistical support, which are crucial for successful model deployment. The approach enabled continuous learning, refining strategies based on real-time feedback and data. Strategies were periodically validated through external collaborations. This iterative process significantly improved AMTSL practices, achieving nearly universal uterotonic administration. Periodic reviews and supportive supervision further bolstered implementation, culminating in plans for district-wide scale-up. SAMVEG acknowledges CLA's pivotal role in designing the model concept and theory of change and in identifying AMTSL strengthening as the main entry point for model scale-up and sustainability. This approach helped us create win-win partnerships and facilitated localization support in improving maternal health outcomes. This approach optimized drug utilization and established a blueprint for future public health initiatives, emphasizing adaptive learning and collaborative partnerships to address complex health challenges effectively.