TABLE 3.
Baseline Assumptions for Model
| Sub-Saharan Africa 2020 Baseline Assumptions | ||||
|---|---|---|---|---|
| Intervention | Metric | Home | Clinic | Hospital |
| Prevention Interventions | ||||
| Uterine massage to prevent PPH | Penetration | 50% | 95% | 100% |
| Utilization | 35% | 40% | 45% | |
| Efficacy | 40% | 40% | 40% | |
| Oxytocin to prevent PPH | Penetration | 0% | 60% | 80% |
| Utilization | 0% | 65% | 65% | |
| Efficacy | 50% | 50% | 50% | |
| Misoprostol to prevent PPH | Penetration | 5% | 15% | 20% |
| Utilization | 55% | 65% | 65% | |
| Efficacy | 43% | 43% | 43% | |
| Drape (to determine blood loss) | Penetration | 0% | 0% | 1% |
| Utilization | 0% | 0% | 10% | |
| Efficacy | 92% | 92% | 92% | |
| Recognize PPH | Penetration | 50% | 0% | 0% |
| Utilization | 60% | 0% | 0% | |
| Efficacy | 60% | 60% | 60% | |
| Clinical diagnosis of PPH | Penetration | 0% | 85% | 90% |
| Utilization | 0% | 80% | 90% | |
| Efficacy | 0% | 70% | 70% | |
| Recognize retained placenta | Penetration | 50% | 0% | 0% |
| Utilization | 15% | 0% | 0% | |
| Efficacy | 70% | 70% | 70% | |
| Clinical diagnosis of a etiology of PPH (lacerations, atonic uterus, retained placenta) | Penetration | 0% | 85% | 90% |
| Utilization | 0% | 65% | 80% | |
| Efficacy | 0% | 85% | 85% | |
| Ultrasound for retained placenta | Penetration | 0% | 0% | 25% |
| Utilization | 0% | 0% | 10% | |
| Efficacy | 85% | 85% | 85% | |
| Manual removal of retained placenta | Penetration | 30% | 75% | 99% |
| Utilization | 30% | 40% | 45% | |
| Efficacy | 70% | 70% | 70% | |
| D&C, manual removal | Penetration | 0% | 30% | 70% |
| Utilization | 0% | 30% | 40% | |
| Efficacy | 90% | 90% | 90% | |
| Surgery for retained placenta | Penetration | 0% | 0% | 75% |
| Utilization | 0% | 0% | 50% | |
| Efficacy | 92% | 92% | 92% | |
| Recognize lacerations | Penetration | 50% | 0% | 0% |
| Utilization | 15% | 0% | 0% | |
| Efficacy | 70% | 70% | 70% | |
| Treatment Interventions | ||||
| Clinical diagnosis of a etiology of PPH (lacerations, atonic uterus, retained placenta) | Penetration | 0% | 85% | 90% |
| Utilization | 0% | 65% | 80% | |
| Efficacy | 0% | 85% | 85% | |
| Suturing | Penetration | 30% | 80% | 95% |
| Utilization | 50% | 70% | 95% | |
| Efficacy | 90% | 90% | 90% | |
| Surgery – lacerations | Penetration | 0% | 0% | 75% |
| Utilization | 0% | 0% | 50% | |
| Efficacy | 92% | 92% | 92% | |
| Recognize atonic uterus | Penetration | 50% | 0% | 0% |
| Utilization | 15% | 0% | 0% | |
| Efficacy | 15% | 15% | 15% | |
| Clinical diagnosis of a etiology of PPH (lacerations, atonic uterus, retained placenta) | Penetration | 0% | 85% | 90% |
| Utilization | 0% | 65% | 80% | |
| Efficacy | 0% | 85% | 85% | |
| Ultrasound – atonic uterus | Penetration | 0% | 0% | 25% |
| Utilization | 0% | 0% | 10% | |
| Efficacy | 85% | 85% | 85% | |
| Uterine massage to treat PPH | Penetration | 50% | 95% | 100% |
| Utilization | 35% | 60% | 80% | |
| Efficacy | 40% | 40% | 40% | |
| Oxytocin to Treat PPH | Penetration | 0% | 60% | 80% |
| Utilization | 0% | 65% | 65% | |
| Efficacy | 50% | 50% | 50% | |
| Misoprostol to Treat PPH | Penetration | 5% | 15% | 20% |
| Utilization | 55% | 65% | 65% | |
| Efficacy | 43% | 43% | 43% | |
| Balloon tamponade | Penetration | 0% | 0% | 0% |
| Utilization | 0% | 0% | 0% | |
| Efficacy | 0% | 0% | 0% | |
| Surgery – atonic uterus | Penetration | 0% | 0% | 75% |
| Utilization | 0% | 0% | 50% | |
| Efficacy | 92% | 92% | 92% | |
| Recognize severe haemorrhage | Penetration | 50% | 0% | 0% |
| Utilization | 70% | 0% | 0% | |
| Efficacy | 80% | 0% | 0% | |
| Clinical diagnosis of severe haemorrhage | Penetration | 0% | 85% | 90% |
| Utilization | 0% | 90% | 99% | |
| Efficacy | 0% | 95% | 95% | |
| Fluid resuscitation | Penetration | 0% | 50% | 99% |
| Utilization | 0% | 70% | 80% | |
| Efficacy | 5% | 5% | 5% | |
| Blood replacement and transfusion | Penetration | 0% | 5% | 45% |
| Utilization | 0% | 50% | 80% | |
| Efficacy | 95% | 95% | 95% | |
| Impact of Transfer | ||||
| Transfer with diagnosis of PPH | Home to clinic | 30% | ||
| Home to hospital | 15% | |||
| Clinic to hospital | 35% | |||
| Transfer with diagnosis of retained placenta | Home to clinic | 30% | ||
| Home to hospital | 15% | |||
| Clinic to hospital | 35% | |||
| Transfer with diagnosis of lacerations | Home to clinic | 30% | ||
| Home to hospital | 15% | |||
| Clinic to hospital | 35% | |||
| Transfer with diagnosis of atonic uterus | Home to clinic | 30% | ||
| Home to hospital | 15% | |||
| Clinic to hospital | 35% | |||
| Transfer with diagnosis of severe haemorrhage | Home to clinic | 30% | ||
| Home to hospital | 20% | |||
| Clinic to hospital | 40% | |||
Abbreviations: D&C, dilation and curettage; PPH, postpartum haemorrhage.