The GDG acknowledged that the implementation of formal protocols is a complex process that will require the local adaptation of general guidelines.

• Formal protocols should define clear roles and responsibilities within the PPH care team and include timelines for intervention, escalation procedures and referral pathways.
• Protocols should be simple, action-oriented and easy to implement in the clinical environment, especially in settings with high workloads or limited staffing.
• Protocols should be integrated into routine training, clinical supervision and continuous quality improvement activities to ensure consistent use and adherence.
• The GDG emphasized that protocols should be evidence-based and regularly updated in line with evolving recommendations and local audit findings.
• Facilities should monitor implementation of PPH protocols through routine audits and feedback loops to ensure that they are being followed and remain relevant to clinical realities.
• Protocols should also support respectful maternity care by incorporating practices that preserve dignity, informed decision-making and communication with women and their families during emergencies.