Strengthening emergency obstetric care by using non-pneumatic anti-shock garment and closed user group mobile phone
Obstetric hemorrhage is the leading cause of maternal death. In Tanzania, PPH alone contributes up to 28% of total maternal deaths annually. In addition, 28% of women who die from hemorrhage deliver in a hospital. One tool to aid in preventing these deaths is the Non-pneumatic Anti-Shock Garment (NASG). The NASG is a low technology compression device, which, when placed around the lower body of a woman with obstetric hemorrhage, will decrease bleeding, reverse shock, and buy the woman time until she can reach definitive care. The NASG, often referred to as Life-Wrap, is a relatively low cost tool for saving lives. Another contributor to maternal death from hemorrhage are problems with communications, the Closed User Group Emergency Phone (CUG) is another innovation, and was used to enhance emergency communications.
A number of studies have been conducted to document the NASGs’ effectiveness and in its 2012 Global recommendations, WHO stated, “The use of NASGs is recommended as a temporizing measure for obstetric haemorrhage.” This followed peer-reviewed publication of evidence from various studies including results from studies conducted at tertiary level facilities in Nigeria, Egypt, Zambia, Zimbabwe, and India which showed a 50% decrease in maternal deaths from hemorrhage, markedly reduced blood loss, and much faster recovery from shock. Data from 3,651 women were examined in a pooled analysis and showed a 59% significantly reduced odds of mortality among the women with the most severe shock. A recent randomized cluster trial of NASG application at primary health care centers before women in shock were transported to tertiary level facilities, showed similar decreases in mortality and faster shock recovery.