Maternal Health Commodities: Looking beyond medicines

This post is part of a blog series on maternal health commodities. To view the entire series, click here.

Written by: the Fistula Care team at EngenderHealth.

The UN Commission on Life-Saving Commodities is working to improve access to essential but overlooked maternal health medicines, such as oxytocin, misoprostol, and magnesium sulfate. This is welcomed, wonderful news: Proper access to these drugs will save the lives of many women every year. As we consider how to improve mothers’ health worldwide, however, we must recognize that life-saving medicines are only a part of the story. Facilities require equipment and supplies to save lives, too.

On the USAID-funded Fistula Care project, we at EngenderHealth have given some thought to the essential obstetric equipment that hospitals should have on hand. As it turns out, very little on our equipment list is exclusively for genital fistula repair surgery. The same retractors, specula, scissors, scalpels, and forceps can largely be used not only to repair fistula, but also to enable health providers to carry out cesarean sections, laparotomy and other surgeries. That is, the same tools that enable trained surgeons to repair fistula can also allow hospital staff to provide the comprehensive emergency obstetric care that will prevent fistula – not to mention maternal deaths.

Equipment requirements go beyond surgical kits: Autoclaves, operating tables, and appropriate lighting can improve care hospital-wide. All equipment – both large and small – must be appropriately maintained and, when necessary, repaired. Ensuring local capacity for maintenance and repair is therefore essential.

A functioning surgical service also needs supplies – items like gloves, disinfectant, gauze, and sutures that will naturally be used up and need replenishing. These items share the supply chain needs of the essential medicines, and it follows logically that improving access to lifesaving drugs could efficiently translate into systems able to maintain and appropriately distribute necessary consumables, too.

Costing of consumables for maternal health is acknowledged as an issue that has not received sufficient attention. Our recent cost study assessed the average consumption of supplies related specifically to fistula surgery. Just like our equipment list, most consumables for fistula repair overlap with those required for emergency obstetric care.

Can the UN commission include equipment and consumables among its concerns? Perhaps not, since its specific focus is central to its success. Nevertheless, all players in the maternal health field would do well to keep in mind that lifesaving medicines are just part of the story. Properly maintained, functional equipment and appropriate consumables also save lives.

Learn more about the Fistula Care project here.