Scaling equitable postpartum haemorrhage prevention: linking health financing, gender equity, and community birthing knowledge
Original framing: “[Series] Prevention of postpartum haemorrhage: from evidence to implementation at scale” — The Lancet
Frontline testimonies from women in informal settlements, Indigenous reserves, and refugee camps reveal barriers such as transport delays, language gaps, and fear of disrespectful care. Health workers from these communities report burnout caused by inadequate supplies and top‑down protocols that ignore local realities. Amplifying these voices reshapes policy priorities toward equity and cultural safety.
Maternal mortality from postpartum haemorrhage persists because biomedical tools are deployed within under‑funded, gender‑biased health systems that marginalise Indigenous and community knowledge.
Historical patterns of colonial obstetrics and contemporary austerity reveal that the problem is structural, not merely technical. By weaving together indigenous practices, cross‑cultural midwifery models, and robust scientific evidence, we can design a hybrid prevention framework that respects cultural rites while ensuring reliable uterotonic access. This requires equitable financing, gender‑responsive policies, and a data platform that centers marginalized voices, thereby transforming PPH prevention from a drug‑centric fix into a systemic, culturally attuned public health achievement.