Safeguarding the Quality of Maternal Medicine to Save Mothers' Lives

Each year, an estimated 287,000 women worldwide die giving birth. Postpartum hemorrhage causes more than a quarter of these deaths, despite an affordable and lifesaving medicine that can easily prevent and treat it: oxytocin.

The World Health Organization recommends a preventative dose of oxytocin to all women in the third stage of labor to prevent postpartum hemorrhage. GHSC-PSM procures oxytocin for mothers like this one in Madagascar. Photo credit: Lan Andrian

Topics:

Logistics

Procurement

Maternal and Child Health

Date

January 24, 2018

In October 2017, in Geneva, Switzerland, GHSC-PSM, along with the Reproductive Health Supplies Coalition (RHSC) and PATH, brought together a diverse coalition of medicine manufacturers, national governments, universities, nongovernmental organizations, and global health practitioners. Their shared goal was to reduce preventable maternal deaths by making high-quality oxytocin more readily available in low- and middle-income countries.

More than 30 representatives gathered to discuss the common issue of oxytocin being stored in too-warm conditions, which causes it to degrade and become significantly less effective. Studies across low- and middle-income countries have found substandard and poor-quality oxytocin in circulation.

The meeting resulted in evidence-based recommendations — agreed to by an inclusive group of stakeholders — for cold storage of oxytocin, regardless of the sometimes incorrect instructions on the label. In the nearly 60 countries where GHSC-PSM works, the project will promote these recommendations and work with local health and supply chain managers to ensure oxytocin’s safe storage and distribution.

Because oxytocin is sensitive to heat, it needs to be stored in refrigerated warehouses, trucks, and health facilities with temperatures between 2 and 8°C — a significant and expensive challenge for resource-constrained countries with poor health care infrastructure. Awareness of these parameters is inconsistent among manufacturers, pharmacists, and healthcare providers.

Hosted and organized by GHSC-PSM, RHSC, and PATH, the meeting was attended by more than 30 experts representing an inclusive group of stakeholders from various fields. Photo credit: GHSC-PSM

Event participants reviewed the current scientific evidence on storing oxytocin, defined and agreed on storage requirements, and developed a plan to raise awareness. Key recommendations include:

Procure only oxytocin that is quality assured and labeled for storage between 2 and 8°C, as inconsistent labelling has led to confusion about storage temperature requirements for oxytocin.
Always store oxytocin at 2–8°C, even if the label indicates it can be kept at higher temperatures.
Where possible, integrate oxytocin storage and distribution into existing cold chains, such as those for vaccines.

GHSC-PSM is continuing to work with RHSC and other stakeholders to promote these recommendations, which have the potential to fundamentally change how oxytocin is marketed, labeled, stored, and distributed.

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