Public Health/Global Health
Poster Session 1
Kwame Adu-Bonsaffoh, MD, MSc, PhD (he/him/his)
Associate Professor
University of Ghana Medical School
Accra, Greater Accra, Ghana
Paola Del Cueto, MD
Research Fellow
Massachusetts General Hospital
Boston, MA, United States
Kate Obayagbona, MD
Research Fellow
Program for Surgery and Social Change and
Boston, MA, United States
Rohini Dutta, MD
Research Collaborator
Program in Global Surgery and Social Change
Brookline, MA, United States
Mehreen Zaigham, MD (she/her/hers)
Associate Professor
Program for Surgery and Social Change and
Boston, MA, United States
Grace Newman, BSc,MBBS
Resident Doctor
Korle-Bu Teaching Hospital
Accra-North, Armed Forces Africa, Canada, Europe, Middle East, Ghana
Henry Kumi, MD
Korle-Bu Teaching Hospital
Accra, Greater Accra, Ghana
Abonie Maclean, MBBS
Korle-Bu Teaching Hospital
Accra, Ghana, Ghana
Solomon Armah, MD
Korle-Bu Teaching Hospital
Accra, Greater Accra, Ghana
Henry Mark Mark Lugobe, MBBCH
Obstetrician and Gynecologist
Mbarara University of Science and Technology
Mbarara, Mbarara, Uganda
Isaac Nsiah, MD
Korle-Bu Teaching Hospital
Accra, Greater Accra, Ghana
Nicholas Musinguzi, MSc
Center for Global Health
Boston, MA, United States
Chris Fofie, MD
Ghana Health Services
Accra, Greater Accra, Ghana
Adeline A. Boatin, MD, MPH (she/her/hers)
Assistant Professor
Massachusetts General Hospital
BOSTON, MA, United States
Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. Tranexamic acid (TXA) is a promising intervention for excessive bleeding after childbirth, and is recommended by the World Health Organization for the treatment of PPH. However, there is limited real-world data on current use patterns of TXA in low and middle-income countries, including Ghana. We aimed to assess the utilization of tranexamic acid among women delivering at referral-level facilities in Ghana using electronic medical record (EMR) data and describe variation in use by facility, delivery volume at each facility, and mode of delivery.
Study Design: Data was obtained from Lightwave Health Information System (LHIMS), an EMR system implemented across referral facilities in Ghana in 2018. Clinical information is entered into LHIMS by clinicians engaged in patient care. We retrieved data on medicines prescribed, mode of delivery and patient demographics on all births occurring at five regional referral hospitals between August and November 2022. We compared the proportion of births in which TXA was prescribed by facility, delivery volume, patient demographics, and mode of delivery.
Results: Data were available on 3723 births from five facilities. The overall proportion of births in which TXA was prescribed was 20.9% and varied significantly across facilities from 3.5% to 45%. Prescription rates were higher among women delivered by cesarean section compared to those delivered vaginally (51.4% vs 4.3%; p< 0.001). We found no differences in prescription of TXA by age, education or occupation of women delivered, or by delivery volume.
Conclusion: We demonstrate the use of a national-level EMR to assess peripartum TXA prescription patterns in Ghana, revealing significant variation in TXA use across referral hospitals in the country and by mode of delivery. Further work is needed to understand variation in practice by facilities and mode of delivery to optimize adherence to recommended practice guidelines