When Communities Take Action: A tale of two life-saving drugs

May 22, 2014



The USAID-funded Targeted States High Impact Project (TSHIP) has released a video about a simple, low-cost intervention that is saving the lives of mothers and babies in northern Nigeria.

UPDATE: The Huffington Post has published a blog by JSI President Joel Lamstein detailing the maternal and newborn health crisis in Nigeria, and how a community-based intervention led by JSI is helping to address it. Read the article, "Simple Solutions to Global Problems: How Two Medicines Promise Life for Mothers and Infants in Nigeria" on The Huffington Post.

Due to poverty, lack of access to health facilities, and harmful traditional practices, 95% of women in Sokoto, Nigeria give birth at home, 20 percent of the time with no one else present. Under these conditions, even minor complications during delivery can turn fatal for mother and baby. Postpartum hemorrhage (excessive bleeding after child birth) is particularly dangerous for women who give birth at home with no attendance and no access to medical care. Born into an unsterile environment, newborns are vulnerable to infection, particularly of the umbilical stump; infection of the umbilical stump accounts for 1 out of every 3 newborn deaths in Nigeria.

The TSHIP project, implemented by a JSI led consortium in Nigeria’s Bauchi and Sokoto States, is turning the tide on maternal and newborn mortality by training thousands of community based health volunteers distribute and educate women on the use of misoprostol, a drug that prevents postpartum hemorrhage, and chlorhexidine, an antiseptic gel that, when applied to the umbilical stump, protects newborns from life-threatening infection.

TSHIP worked closely with local leadership to increase awareness and acceptance of misoprostol and chlorhexidine, and worked with the state governments to develop procurement and supply chain systems that deliver the drugs at low cost all the way down to the community level. In March 2013, Sokoto State used its own funds to procure chlorhexidine, making it the first government in Africa to launch a chlorhexidine program. Within four months of launching the misoprostol and chlorhexidine intervention, 20,000 pregnant women in Sokoto received and were counseled on the use of the drug pair. Bauch State recorded similar progress soon after it launched its program in December 2013.

The successful roll-out of misoprostol and chlorhexidine in Sokoto State has served as a call to action for other states to launch this life-saving program. To increase cost effectiveness and prepare for growing demand, TSHIP has worked with the government and private sector to shift production of chlorhexidine to local manufacturers. In March 2014, Drugfield Pharmaceutical Limited, a Nigerian manufacturing firm, became the first African company to receive regulatory approval to manufacture chlorhexidine gel for newborn cord care. In April, the first shipments were sent to Gombe state and Haiti.

Watch “When Communities Take Action: A tale of two life-saving drugs” on YouTube

Read an article in the Wall Street Journal highlighting TSHIP’s exemplary work using a low-tech intervention to transform neonatal health outcomes.