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Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise
Williams, Caitlin R Adnet, Guervan Gallos, Ioannis D Gülmezoglu, A Metin Rushwan, Sara Widmer, Mariana Althabe, Fernando Oladapo, Olufemi T
Williams, Caitlin R
Adnet, Guervan
Gallos, Ioannis D
Gülmezoglu, A Metin
Rushwan, Sara
Widmer, Mariana
Althabe, Fernando
Oladapo, Olufemi T
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Epub Date
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2024-11-07
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Abstract
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.
Citation
Caitlin R Williams, Guervan Adnet, Ioannis D Gallos, Arri Coomarasamy, A Metin Gülmezoglu, Md Asiful Islam, Sara Rushwan, Mariana Widmer, Fernando Althabe, Olufemi T Oladapo - Research agenda for ending preventable maternal deaths from postpartum haemorrhage: a WHO research prioritisation exercise: BMJ Global Health 2024;9:e015342.
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PubMed ID
39510550 (pubmed)
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Journal article
Language
en
Description
© 2024 The Authors. Published by BMJ Publishing Group. This is an open access article available under a Creative Commons licence.
The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1136/bmjgh-2024-015342
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ISSN
2059-7908
EISSN
2059-7908
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Sponsors
This work was supported by MSD for Mothers, Bill & Melinda Gates Foundation and UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a cosponsored programme executed by the WHO (Award No. HQHRP2220228-22.1-74309).
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Licence for published version: Creative Commons Attribution 4.0 International