- Heat Stable Carbetocin, a medication for preventing excessive bleeding during and after birth, has been added to the list, granting all health facilities in Kenya the authority to utilize this drug.
- Mid last year, medical practitioners at the Malindi Sub-County Hospital in Kilifi County came up with an innovation aimed to help reduce postpartum haemorrhage among women.
- The ripple effects of maternal mortality go beyond just the baby to place newborns at heightened risk of mortality within their first two years of life.
In a groundbreaking move aimed at reducing maternal mortality rates, the Ministry of Health (MoH) has taken significant strides to ensure access to life-saving medications for women during childbirth.
The inclusion of Heat Stable Carbetocin and tranexamic acid in the country’s essential medicines list marks a transformation in the country’s healthcare industry.
This innovation was introduced at the Kenya Obstetrical and Gynaecological Society (KOGS) 48th annual summit that was held in Mombasa County from February 12 to 16, 2024.
About Heat Stable Carbetocin
Heat Stable Carbetocin, a medication for preventing excessive bleeding during and after birth, has been added to the list, granting all health facilities in Kenya the authority to utilize this drug.
Unlike its predecessor, Oxytocin, Heat Stable Carbetocin does not require refrigeration, making it particularly suitable for resource-limited settings such as the Northern parts of Kenya where refrigeration infrastructure may be lacking.
Jackline Mainye, the acting Director of Commercial Services at the Kenya Medical Supplies Agency (KEMSA), heralded the move, emphasizing the significant reduction in the cost of Heat Stable Carbetocin.
“In a few weeks, counties can now order the medicine from KEMSA at a fair price of KSh92 per dose, a drop in price from KSh1,444 per dose,” said Mainye.
She explained that the drastic price drop is poised to make the medication accessible to a wider population, particularly within the public health sector where affordability has long been a barrier to adequate healthcare provision.
KEMSA is currently in the procurement process for Heat Stable Carbetocin, with the first batch expected to arrive in the country by March 2024.
This development in medicine marks a critical shift, as previously, the medication was predominantly available in the private sector, rendering it financially out of reach for many public health facilities.
Postpartum hemorrhage, deadly motherhood
A study by the World Health Organization (WHO) indicates that each year, about 14 million women experience Postpartum Haemorhage (PPH) resulting in about 70,000 maternal deaths globally.
Dr. Daisy Ruto, an Obstetric Gynaecologist from the Johns Hopkins Affiliate known for its maternal and child health, Jhpiego, cited severe bleeding as one of the killers underscoring the importance of critical intervention in preventing maternal fatalities.
“Bleeding excessively after birth can kill a healthy woman within hours if she is unattended and providing quality access to uterotonics such as Oxytocin, Heat Stable Carbetocin and the others, immediately after childbirth effectively reduces the risk of bleeding,” noted Dr. Ruto.
In Kenya, the leading cause of maternal mortality is postpartum hemorrhage, defined as more than 500 milliliters of blood loss after birth, which kills the equivalent of one woman every six minutes.
Mid last year, medical practitioners at the Malindi Sub-County Hospital in Kilifi County came up with an innovation aimed to help reduce postpartum haemorrhage among women.
The project, led by Maureen Were, a lead Obstetrician Gynaecologist at the Malindi Sub-County Hospital, developed a gadget after a pilot project conducted using the E-MOTIVE technology in four African countries, including Kenya.
However, the project experienced challenges after access to the graduated drip was limited.
“After the study ended, we got the challenge of not having the graduated drip and so we had to think of ways to continue with the accurate measure of blood because for us we had seen the importance of using proper accurate estimation so that we don’t under diagnose PPH,” said Were.
A shift, uterotonics components
Access to uterotonics such as Oxytocin and Heat Stable Carbetocin immediately following childbirth is essential in averting tragic outcomes and safeguarding the well-being of both mothers and their newborn babies.
Additionally, tranexamic acid, a medication with demonstrated efficacy in reducing maternal bleeding when administered promptly, has also been incorporated into the essential medicines list.
Backed by extensive research validating its effectiveness in mitigating postpartum hemorrhage, tranexamic acid represents another important tool in the fight against maternal mortality.
The Reproductive Health Supplies Coalition (RHSC), a maternal health expert group, identifies other uterotonics medicine that cause the uterus to contract include oxytocin, ergometrine, misoprostol, Carbetocin and syntometrine; a combination recommended by WHO.
The group discovered that despite its effectiveness, oxytocin requires refrigeration of 2-8°C to remain potent.
Nonetheless, the new Heat Stable Carbetocin beats the challenge as it requires no refrigeration and meets WHO’s Good Manufacturing Practices and contains 90% of the Active Pharmaceutical Ingredient (API).
Government inclusion
The proactive approach adopted by Kenyan government in medicine extends beyond just policy implementation.
Governor Mutula Kilonzo of Makueni County, in attendance at the KOGS Summit in Mombasa, spearheaded efforts to integrate these life-saving medications into the local healthcare system.
The governor stated that his county stands as an example as he has started on the journey to incorporate the new medicine in his county hospitals.
“I have allocated resources to mitigate excessive bleeding after birth through introducing innovations that are backed up by research in Makueni County,” said Governor Kilonzo.
The pivotal role of partnerships in driving transformative change cannot be overstated.
Through collaborations with initiatives such as the Amplifying Measurable Progress and Leveraging Investments for Postpartum Hemorrhage Impact (AMPLIPPHI), supported by UNITAID, Kenya has been able to pilot the integration of these medications within its health system.
The success witnessed in Makueni County underscores the power of strategic collaborations in effecting tangible improvements in healthcare outcomes.
Further, he described how, through the support of a UNITAID-supported project, Accelerating Measurable Progress and Leveraging Investments for Postpartum Haemorrhage Impact—AMPLIPPHI, pronounced Amplify— tested the integration of medicine in a health system in Makueni County which was used by the government as a pilot for how the medication works.
He urged other counties to follow suit and allocate resources to save lives.
“Saving mothers from postpartum bleeding is criticaL, especially with innovations like Heat Stable Carbetocin, and procurement of quality-assured PPH medicines; we must act now. Let’s allocate resources to ensure these interventions reach every delivery room in Kenya,” added the Governor.
The urgency of the Ministry of Health and global partnerships in addressing maternal mortality cannot be overstated seeing that woman dies during pregnancy or childbirth every two minutes globally, with postpartum hemorrhage accounting for a significant portion of these fatalities.
The ripple effects of maternal mortality go beyond just the baby to place newborns at heightened risk of mortality within their first two years of life.
In conclusion, Kenya’s proactive measures to enhance access to affordable, life-saving medications represent a significant milestone in the nation’s journey towards achieving maternal health equity.
YOU MAY ALSO LIKE: Boosting Immunity: Neglected and underutilized crops could improve health
By prioritizing innovation, affordability, and evidence-based interventions, Kenya sets a great example for global efforts to combat maternal mortality and ensure the right to quality healthcare for all.
