The High Cost of Hemorrhage: A Systems Failure in Maternal Care
A cross-sectional survey in Zambia’s public hospitals reveals critical gaps in managing postpartum hemorrhage (PPH), a leading cause of maternal death. Analyzing over 74,000 deliveries, researchers found that while oxytocin is universally available, access to tranexamic acid (TXA) is limited to just 58% of facilities. The study employed an ingredients-based costing model to compare an ideal care pathway at a primary facility against a fragmented referral system. The results show that managing a severe PPH case through referral costs 18.6% more, translating to a national avoidable economic burden exceeding $133,000 annually. The findings underscore that strengthening primary-level facilities with essential commodities and surgical capacity is vital for both cost containment and mortality reduction.
Why it might matter to you: This study highlights a critical systems-level challenge in managing acute gastrointestinal bleeding, mirroring the complexities you face in conditions like variceal hemorrhage. The economic and clinical inefficiency of a fragmented referral pathway offers a powerful model for analyzing care delivery in hepatology and gastroenterology. It reinforces the strategic imperative to equip frontline settings with definitive therapies to improve outcomes and control costs in time-sensitive emergencies.
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