Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise

Introduction Postpartum haemorrhage (PPH) remains the leading cause of maternal death. Yet there is a lack of clarity around what research is needed to determine what works and how best to deliver proven PPH interventions. This article describes a WHO-led effort to develop a global PPH research agen...

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Main Authors: Fernando Althabe, Olufemi T Oladapo, Arri Coomarasamy, A Metin Gülmezoglu, Mariana Widmer, Ioannis D Gallos, Caitlin R Williams, Guervan Adnet, Md Asiful Islam, Sara Rushwan
Format: Article
Language:English
Published: BMJ Publishing Group 2024-11-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/9/11/e015342.full
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author Fernando Althabe
Olufemi T Oladapo
Arri Coomarasamy
A Metin Gülmezoglu
Mariana Widmer
Ioannis D Gallos
Caitlin R Williams
Guervan Adnet
Md Asiful Islam
Sara Rushwan
author_facet Fernando Althabe
Olufemi T Oladapo
Arri Coomarasamy
A Metin Gülmezoglu
Mariana Widmer
Ioannis D Gallos
Caitlin R Williams
Guervan Adnet
Md Asiful Islam
Sara Rushwan
author_sort Fernando Althabe
collection DOAJ
description Introduction Postpartum haemorrhage (PPH) remains the leading cause of maternal death. Yet there is a lack of clarity around what research is needed to determine what works and how best to deliver proven PPH interventions. This article describes a WHO-led effort to develop a global PPH research agenda for 2023–2030, to reinvigorate research and innovation while avoiding duplication and waste.Methods Potential questions were culled from evidence gaps in a forthcoming Lancet PPH series, a pipeline analysis on PPH medicines and devices, international PPH guidelines, previous research prioritisation efforts and submissions from a reference group of PPH experts and stakeholders. Questions were deduplicated and consolidated, categorised into three tracks (innovation, implementation and cross-cutting) and subjected to an online prioritisation survey. Survey participants (n=120) assessed these questions using five criteria (answerability, effectiveness, deliverability, maximum potential for disease burden reduction and equity) following the Child Health and Nutrition Research Initiative methodology. The outcome of this exercise was complemented by an in-person consensus meeting (Global PPH Summit from 7 March 2023 to 10 March 2023 in Dubai, United Arab Emirates) to finalise the research agenda.Results Fifteen research questions (five per track) were identified as top priority. The top question per track called for research on the comparative effectiveness and safety of alternative routes of administration (other than the intravenous route) of tranexamic acid in the treatment of PPH (innovation); identifying barriers and facilitators affecting the adoption and use of evidence-based recommendations for PPH management (implementation) and the effectiveness of a strategy of early detection and first response treatment using a bundle of recommended interventions for improving PPH-related outcomes (cross-cutting).Conclusion This shared research agenda should guide future investments into PPH studies with high potential to transform policy and clinical practice in the near term to medium term. Funding for the new research priorities is urgently needed.
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spelling doaj-art-08f584641a2240afb79e46219b1beac02024-11-26T23:10:08ZengBMJ Publishing GroupBMJ Global Health2059-79082024-11-0191110.1136/bmjgh-2024-015342Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exerciseFernando Althabe0Olufemi T Oladapo1Arri Coomarasamy2A Metin Gülmezoglu3Mariana Widmer4Ioannis D Gallos5Caitlin R Williams6Guervan Adnet7Md Asiful Islam8Sara Rushwan9UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandWHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UKConcept Foundation, Geneva, SwitzerlandUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandUNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandDepartment of Mother and Child Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, ArgentinaBoston Consulting Group, Paris, FranceWHO Collaborating Centre for Global Women’s Health, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UKConcept Foundation, Geneva, SwitzerlandIntroduction Postpartum haemorrhage (PPH) remains the leading cause of maternal death. Yet there is a lack of clarity around what research is needed to determine what works and how best to deliver proven PPH interventions. This article describes a WHO-led effort to develop a global PPH research agenda for 2023–2030, to reinvigorate research and innovation while avoiding duplication and waste.Methods Potential questions were culled from evidence gaps in a forthcoming Lancet PPH series, a pipeline analysis on PPH medicines and devices, international PPH guidelines, previous research prioritisation efforts and submissions from a reference group of PPH experts and stakeholders. Questions were deduplicated and consolidated, categorised into three tracks (innovation, implementation and cross-cutting) and subjected to an online prioritisation survey. Survey participants (n=120) assessed these questions using five criteria (answerability, effectiveness, deliverability, maximum potential for disease burden reduction and equity) following the Child Health and Nutrition Research Initiative methodology. The outcome of this exercise was complemented by an in-person consensus meeting (Global PPH Summit from 7 March 2023 to 10 March 2023 in Dubai, United Arab Emirates) to finalise the research agenda.Results Fifteen research questions (five per track) were identified as top priority. The top question per track called for research on the comparative effectiveness and safety of alternative routes of administration (other than the intravenous route) of tranexamic acid in the treatment of PPH (innovation); identifying barriers and facilitators affecting the adoption and use of evidence-based recommendations for PPH management (implementation) and the effectiveness of a strategy of early detection and first response treatment using a bundle of recommended interventions for improving PPH-related outcomes (cross-cutting).Conclusion This shared research agenda should guide future investments into PPH studies with high potential to transform policy and clinical practice in the near term to medium term. Funding for the new research priorities is urgently needed.https://gh.bmj.com/content/9/11/e015342.full
spellingShingle Fernando Althabe
Olufemi T Oladapo
Arri Coomarasamy
A Metin Gülmezoglu
Mariana Widmer
Ioannis D Gallos
Caitlin R Williams
Guervan Adnet
Md Asiful Islam
Sara Rushwan
Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise
BMJ Global Health
title Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise
title_full Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise
title_fullStr Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise
title_full_unstemmed Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise
title_short Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise
title_sort research agenda for ending preventable maternal deaths from postpartum haemorrhage a who research prioritisation exercise
url https://gh.bmj.com/content/9/11/e015342.full
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