We work with national program managers and key stakeholders to advocate for the key elements of implementation that are necessary for long-term success such as policies that support consistent availability of quality-assured PPH medicines at all appropriate levels of the health system, funding availability to support national scale-up, improved pharmacovigilance, dissemination of national guidelines to frontline providers, and improved awareness of PPH care at the community level.

Following successful advocacy efforts, we will conduct key steps to help build capacity:

• Updating national policies, clinical guidelines, and resources to integrate PPH approaches and three key medicines: heat-stable carbetocin (HSC), tranexamic acid (TXA), and misoprostol.
• Applying a “low-dose, high-frequency” training approach, whereby providers receive training onsite to incorporate the three medicines into clinical practice.

AMPLI-PPHI is coordinating and collaborating with key stakeholders at both global and country levels to build awareness and technical capacity on priority PPH medicines and to secure political and financial support around PPH, positioning countries for long-term success.

While AMPLI-PPHI is working directly in six target countries, the project also has identified 14 exchange countries, five additional states in India, and three additional states in Nigeria to help propel learning with evidence and tools that exchange countries and states could use to accelerate their PPH prevention and management efforts.

AMPLI-PPHI is supporting ministries of health to strengthen health systems so that quality-assured products are available to prevent and manage PPH. We are strengthening public procurement practices by developing guidance and convening workshops for government procurement and regulatory agencies on value-based procurement and price regulation mechanisms. We are also ensuring the correct use of the drugs by strengthening the capacity of health workers participating in the studies.

As countries demonstrate the use of HSC and advanced distribution of misoprostol for PPH prevention and TXA for PPH treatment, demand for these medicines is expected to increase. However, current market conditions for HSC, misoprostol, and TXA can pose challenges to sustained availability of quality-assured products of these medications, whether due to the lack of registered products or high prices of quality-assured products.

To ensure long-term availability of high-quality products after the project concludes, AMPLI-PPHI is developing a business case that forecasts demand for three key PPH drugs, helping to outline the future potential of these markets. This includes conducting pricing surveys to determine fair price benchmarks for PPH drugs and providing technical support to manufacturers to ensure that these products remain affordable and accessible in low- and middle-income countries.