Market Shaping for Essential Maternal Health Commodities

The Challenge

While major strides in reducing maternal mortality have occurred globally since 1990, over 800 women continue to die every day from preventable complications related to pregnancy and childbirth. Post-partum hemorrhage (PPH) and pre-eclampsia/eclampsia (PE/E,) — the two leading causes of maternal mortality — account for 40 percent of all maternal deaths.

Although, effective and low-cost treatments do exist — oxytocin and misoprostol both prevent the bleeding associated with PPH, and magnesium sulfate can be used to treat pre-eclamptic seizures — these three products are often unavailable to women in low- and middle-income countries.

The Opportunity

In 2012, the UN Commission on Life Saving Commodities determined that if oxytocin, misoprostol and magnesium were made more widely available in developing countries, up to six million preventable maternal and child deaths would be averted over five years. The Commission’s report helped draw attention to the significant barriers to access for these commodities, and catalyzed a number of global market shaping efforts to increase the quality and availability of these three essential maternal health products.

In 2015, as the Millennium Development Goals concluded and the development community looked forward to new benchmarks for maternal health, there was a need for a comprehensive assessment, at both the global level and in specific high-burden countries, of the key challenges and opportunities to increasing access to oxytocin, misoprostol and magnesium sulfate.

Our Work

In 2016, R4D completed an analysis that looked at market shaping gaps and opportunities for oxytocin, misoprostol and magnesium sulfate.

This work was conducted at the global level, with three “deep dive” country case studies – Bangladesh, Ethiopia, and Nigeria.  The work culminated in a final report, “Increasing Access to Maternal Health Supplies: A scoping of market-based activities, gaps, and opportunities,” which recommended activities to address supply- and demand-side inefficiencies in the maternal health commodities market.

These market-shaping recommendations included:

  • Increasing the number of high-quality verified products available at the country level;
  • Improving market transparency on product price ranges; and
  • Reducing, when possible, lead times and coordinating country-level procurements.

The report was presented at the 2016 Women Deliver Conference in Copenhagen, Denmark, and used as the basis for a series of global-level and country-level advocacy briefs, developed by PATH and the Reproductive Health Supplies Coalition.


This work is made possible by the Reproductive Health Supplies Coalition (RHSC), with generous funding from the John D. and Catherine T. MacArthur Foundation.



Bangladesh, Ethiopia, Global, Nigeria


Reproductive Health Supplies Coalition (RHSC), John D. and Catherine T. MacArthur Foundation


Reproductive Health Supplies Coalition (RHSC), PATH



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