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Commentary, Journal

Confronting Maternal Mortality Due to Postpartum Hemorrhage and Unsafe Abortion: A Call for Commitment

Karanja J, Muganyizi P, Rwamushalja E, Sahin-Hodoglugil N, Holm E

African Journal of Reproductive Health, 2013

In this commentary co-authored by VSI and the Regional Experts' Summit Group, 35 ob/gyns and public health experts from 12 countries in Africa call for political commitment to expanding access to misoprostol for its many uses in maternal health.

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Journal

“My job is to get pregnant women to the hospital”: a qualitative study of the role of traditional birth attendants in the distribution of misoprostol to prevent post-partum haemorrhage in two provinces in Mozambique

Karen Hobday, Jennifer Hulme, Caroline Homer, Páscoa Zualo Wate, Suzanne Belton, Ndola Prata

African Journal of Reproductive Health, 2018

Background: Post-partum haemorrhage is the leading cause of maternal deaths in Mozambique. In 2015, the Mozambican Ministry of Health launched the National Strategy for the Prevention of Post-Partum Haemorrhage at the Community Level. The strategy included the distribution of misoprostol to women in advance at antenatal care and via Traditional Birth Attendants who directly administer the medication. The study explores the role of Traditional Birth Attendants in the misoprostol program and the views of women who used misoprostol to prevent post-partum haemorrhage. Methods: This descriptive study collected data through in-depth interviews and focus group discussions. Traditional Birth Attendants between the ages of 30–70 and women of reproductive age participated in the study. Data was collected between June–October 2017 in Inhambane and Nampula Provinces. Line by line thematic analysis was used to interpret the data using Nvivo (v.11). Results: The majority of TBAs in the study were satisfied with their role in the misoprostol program and were motivated to work with the formal health system to encourage women to access facility based births. Women who used misoprostol were also satisfied with the medication and encouraged family and friends to access it when needed. Women in the community and Traditional Birth Attendants requested assistance with transportation to reach the health facility to avoid home births. Conclusions: This study contributes to the evidence base that Traditional Birth Attendants are an appropriate channel for the distribution of misoprostol for the prevention of post-partum haemorrhage at the community level. More support and resources are needed to ensure Traditional Birth Attendants can assist women to have safe births when they are unable to reach the health facility. A consistent supply of misoprostol is needed to ensure women at the community level receive this life saving medication. Keywords: Maternal health, Traditional birth attendant, Mozambique, Post-partum Haemorrhage, Misoprostol, Community

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Journal

Big issues deserve bold responses: Population and climate change in the Sahel

Potts M, Graves A

African Journal of Reproductive Health, 2013

Parts  of  Africa  have  the  most  rapid  population growth in the world. Recent studies by climatologists  suggest  that,  in  coming  decades, ecologically vulnerable areas of Africa, including the Sahel will be exposed to the harshest adverse effects of global warming. The threat hanging over parts of sub-Saharan Africa is extreme. Fortunately,  there are evidence-based achievable [...]

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Journal

Community-Based Availability of Misoprostol: Is it safe?

Prata N, Mbaruku G, Grossman A, Holston M, Hsieh K

African Journal of Reproductive Health, 2009

This paper evaluates the safety and acceptability of long-term community-based use of misoprostol for management of postpartum hemorrhage (PPH) in home-births, by comparing deliveries with and without misoprostol use in communities of Kigoma, Tanzania.

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Journal

Prevention of Postpartum Hemorrhage: Options for Home Births in Rural Ethiopia

Prata N, Gessessew A, Abraha A, Holston M, Potts M

African Journal of Reproductive Health, 2009

This paper sought to determine the safety and feasibility of home-based prophylaxis of postpartum hemorrhage (PPH) with misoprostol, including assessment of the need for referrals and additional interventions.

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Commentary

Les grandes questions meritent des responses audacieuses: la population et le changement climatique au Sahel

Potts M, Graves A

African Journal of Reproductive Health, 2013

Certaines régions d’Afrique ont la croissance démographique la plus rapide du monde. Des études récentes menées par les climatologues indiquent que dans les prochaines décennies, les zones écologiquement vulnérables de l’Afrique, y compris le Sahel, seront exposées aux effets néfastes les plus sévères du réchauffement climatique. La menace qui pèse sur certaines régions de l’Afrique [...]

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