Effectiveness of zipline’s drones’ delivery service in improving postpartum hemorrhage (PPH) management and reducing its related mortality and morbidity: A retrospective cross-sectional survey in Rwanda

Background In sub-Saharan Africa, maternal deaths from postpartum hemorrhage (PPH) often result from delayed access to blood products and emergency medicines. To address last-mile delivery challenges, Rwanda launched the Zipline drone delivery project in 2016. This study evaluated the effectiveness of Zipline’s drone service in improving PPH management and reducing related mortality and morbidity. Methods A retrospective cross-sectional design was used to collect data from maternity registries, patient files, and healthcare providers in 13 rural hospitals served by Zipline drones between May and October 2023. Purposive sampling identified the study population. Data were compared across two timeframes: 12 months before and 12 months after Zipline’s implementation. Results Following Zipline’s introduction, maternal deaths from PPH decreased by 46%, with an 11.5-fold reduction in the likelihood of death. Survival rates rose by 21.4%, transfers for PPH dropped by 61%, and average hospitalization duration declined by 40%, from five to three days. PPH-related morbidity fell by 51%, with a 14.6-fold decrease in likelihood. Over 60% of healthcare providers reported that Zipline drones improved PPH management and contributed to reduced maternal mortality. Conclusion Within one year, Zipline drones significantly reduced maternal mortality and PPH complications, demonstrating their potential to address obstetric emergencies. Expanding drone technology to all health facilities and developing larger drones as airborne ambulances could further reduce delays caused by poor infrastructure and long distances, ultimately improving maternal healthcare outcomes.