Lessons from Niger and from a multicountry randomized study on reducing postpartum haemorrhage (PPH) mortality in resource-constrained settings: perspectives for scaling-up across continents, with expansion to eclampsia and other major causes of maternal mortality.

Two large studies published in 2023 report more rapid reductions in postpartum haemorrhage (PPH) mortality after health-facility births than many would think possible in a low- or middle-income country, using very different study designs yet broadly similar interventions. In this commentary and the accompanying study, we report on how Niger is sustaining its nationwide results through four subsequent years among over 2 million health-facility births with little external support. In an era of greatly reduced external funding for health, these studies provide strong justification for testing elsewhere too, to determine whether these approaches should be scaled globally.