The GDG placed a high value on the costs of simulation programmes and acknowledged that there are different types of simulation programmes. Some programmes are high-tech, computerized and costly while others are less expensive and more likely to be affordable in low- and middle-income countries.

• The GDG identified improvement in communication between health care providers and women and their family members as an important priority in the training of health care providers in PPH management. Simulation-based programmes should incorporate communication, leadership and respectful maternity care as core components.
• The target audiences for training include community health workers, traditional birth attendants, nurses, midwives, doctors and emergency medical technicians or paramedics. Local adaptation of training curricula should align with the scope of practice of each cadre and reflect common causes and treatments of PPH in that context.
• Simulation-based training is especially valuable for improving team coordination in time-critical emergencies such as PPH. Regular, team-based drills that mirror real-life scenarios can enhance the clarity of roles, build confidence and reduce delays in implementing appropriate interventions.
• Integrating simulation exercises into routine quality improvement efforts, such as maternal death reviews or clinical audit processes, can enhance their relevance and sustainability, and help translate learning into better preparedness and outcomes.