Shillong, April 4: In a significant step to curb preventable maternal deaths, the Meghalaya government has rolled out the EMOTIVE+ approach, a globally endorsed strategy aimed at tackling postpartum haemorrhage (PPH), which continues to be one of the leading causes of maternal mortality in the state. Officials said PPH accounts for nearly 30–40% of maternal deaths in Meghalaya, with a worrying number of cases occurring within health facilities or during transit, pointing to gaps in timely emergency response.
The initiative is being implemented by the State Health System Resource Centre, Meghalaya, in collaboration with the Regional Health & Family Welfare Training Centre, with support from the Federation of Obstetric and Gynaecological Societies of India under its Project ADHUNA.
The project focuses on strengthening clinical practices to improve intrapartum and essential newborn care, in small private health facilities in select districts of Uttar Pradesh, Bihar, Madhya Pradesh and Odisha.
The EMOTIVE+ model focuses on early detection and rapid management of PPH through a standardised bundle of care that includes timely use of oxytocics, tranexamic acid, IV fluids, and clinical examination, along with uterine massage. A key feature is the use of calibrated drapes to objectively measure blood loss, reducing delays in diagnosis, while life-saving interventions are initiated simultaneously rather than in sequence.
The approach also introduces context-specific innovations such as non-pneumatic anti-shock garments to stabilise patients during referral and uterine balloon tamponade for managing severe cases. Officials said the strategy marks a shift towards a more coordinated, protocol-driven response at healthcare facilities.
The first phase of the rollout is focused on high case-load centres. As part of the effort, three Training of Trainers programmes were conducted this week across West Jaintia Hills, West Khasi Hills and East Khasi Hills, where 79 healthcare personnel were trained to support implementation on the ground. The programme emphasises team-based, multi-cadre training to improve coordination during obstetric emergencies.
Support for the rollout is also being provided by the Gates Foundation India, which is supplying calibrated drapes required for the EMOTIVE bundle. Health officials said the broader goal is to ensure that no woman in Meghalaya dies due to preventable postpartum haemorrhage, whether at a facility or while being referred. They noted that most PPH-related deaths can be avoided with timely diagnosis and prompt treatment, making the successful implementation of EMOTIVE+ crucial for improving maternal health outcomes in the state
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