Table 1. Characteristics of the study countries: trends in the maternal mortality ratio (MMR) proportion of maternal deaths due to PPH, and scale-up of the NASG.

Country	Recent trends in MMR	Burden of PPH	Status of NASG uptake
Ethiopia	MMR decreased between 2005 and 2013 from 740 to 420 deaths per 100,000 live births [1]	Ministry of Health estimates that 10% of maternal deaths are to PPH [18]	Clinton Health Access Initiative introduced NASG in Oromia and Tigray provinces as pilot project in June 2011 [19].
		Unpublished documents suggest that PPH is associated with 25–50% of all maternal deaths [18]	Pilot was followed by expansion nationwide to 110 hospitals (out of 130 total) and 649 health centers (out of 2661 total) and by training of staff in referral hospitals in all 9 regions by April 2014 [19].
			Scale-up strategy based on strong political support and timing.
India	MMR decreased between 2005 and 2013 from 280 to 190 deaths per 100,000 live births [1]	PPH is associated with 30% of all maternal deaths [20]	Pathfinder International (an international NGO) implemented NASG project from 2007–2012—it was approved for use only in the NGO’s project facilities in Rajasthan and Maharashtra states [21].
			Later the project added the states of Bihar, Uttar Pradesh, Odisha (formally Orissa), and Assam [21].
			Tamil Nadu used the NASG in government facilities and did not participate in the Pathfinder International project outside of acquiring the NASGs and receiving the initial training package.
			In 2013 there were about 3,700 NASGs in the Pathfinder International project areas, with an additional 1,200 NASGs in Tamil Nadu alone [21].
			Scale-up strategy differs by state, no country level coordinated plan.
Nigeria	MMR decreased between 2005 and 2013 from 740 to 560 in 2013 [1]	PPH is associated with 30–40% of all maternal deaths [22]	First country to implement the NASG
			Initial UCSF, in collaboration with University College Hospital Ibadan and 14 other facilities, NASG trials, (2003–2007) included Nigeria; a 2008 meeting to disseminate the trial results served as the kick-off for an NASG implementation project led by Pathfinder International [23].
			The Pathfinder International project expanded implementation from 31 facilities in four states in the first year (2007) to 60 health facilities in 7 states by 2014 [23].
			As of 2013, The Pathfinder International project has scaled up to over 5,000 NASGs in circulation in 22 of 36 states [23].
			Scale-up strategy heavily focused on in-country champions.
Zimbabwe	MMR increased by 28% from 1990 to 2010, with a 2010 average MMR of 570 deaths per 100,000 live births [24]	PPH is associated with 34% of maternal deaths [24]	Two referral hospitals and 12 city council-run primary health care maternity clinics in Harare participated in the 2007–2012 UCSF cluster randomized trial of the NASG, in collaboration with University Teaching Hospital (UTH), Lusaka Zambia; U Zimbabwe-UCSF Reproductive Health Research Collaborative and U ZIM, Harare, at the clinic level (before referral to a tertiary hospital) [14]. Those results were released in a national dissemination meeting.
			In 2013, The Ministry of Health stated that it would add the NASG to the government’s essential devices list (NASG Project Coordinator—personal communication).
			Premier Service Medical Investments (PSMI)- a private medical services provision group- is implementing the NASG in Harare and Bulawayo (NASG Project Coordinator—personal communication, September 2014).
			Scale-up strategy still currently hinges on in-country trials.