Developing countries

Women’s Empowerment and Fertility: A Review of the Literature

Ndola Prata
Ushma D. Upadhyay
Jessica D. Gipson
Mellissa Withers
Shayna Lewis
Erica J. Ciaraldi
Ashley Fraser
Megan J. Huchko
2015

Women’s empowerment has become a focal point for development efforts worldwide and there is a need for an updated, critical assessment of the existing evidence on women’s empowerment and fertility. We conducted a literature review on studies examining the relationships between women’s empowerment and several fertility-related topics. Among the 60 studies identified for this review, the majority were conducted in South Asia (n = 35) and used household decision-making as a measure of empowerment (n = 37). Overall, the vast majority of studies found some positive associations between women’s...

Scaling Up Misoprostol to Prevent Postpartum Hemorrhage at Home Births in Mozambique: A Case Study Applying the ExpandNet/WHO Framework

Karen Hobday
Jennifer Hulme
Ndola Prata
Páscoa Zualo Wate
Suzanne Belton
Caroline Homer
2019

Background: Mozambique has a high maternal mortality ratio, and postpartum hemorrhage (PPH) is a leading cause of maternal deaths. In 2015, the Mozambican Ministry of Health (MOH) commenced a program to distribute misoprostol at the community level in selected districts as a strategy to reduce PPH. This case study uses the ExpandNet/World Health Organization (WHO) scale-up framework to examine the planning, management, and outcomes of the early expansion phase of the scale-up of misoprostol for the prevention of PPH in 2 provinces in Mozambique.

Methods:...

Meeting the contraceptive and AIDS prevention needs of people living on a dollar a day

Malcolm Potts
2001

The new millennium sees the largest cohort of young people in history entering its fertile years. Many of these people are too poor to pay the full cost of modern contraception, but the money available for subsidizing their needs is exceedingly limited. The AIDS pandemic is placing additional, unprecedented demand on already overstretched resources. Existing methods of contraception that are well established and off-patent can be produced in bulk at low cost, and will remain the backbone of future programmes. The use of misoprostol as an abortifacient is likely to spread rapidly. New...

Misoprostol and declining abortion-related morbidity in Santo Domingo, Dominican Republic: a temporal association

Suellen Miller
Tara Lehman
Martha Campbell
Anke Hemmerling
Sonia Brito Anderson
Hector Rodriguez
Wilme Vargas Gonzalez
Cordero,g Victor Calderon
2005

OBJECTIVE: To validate anecdotal reports that abortion-related complications decreased in the Dominican Republic after the introduction of misoprostol into the country.

DESIGN: Retrospective records reviews and cross-sectional surveys, interviews and focus groups.

SETTING: Family planning clinics, pharmacies, door-to-door canvassing and a tertiary care maternity hospital in Santo Domingo, Dominican Republic.

POPULATION: Women of reproductive age in Santo Domingo, Dominican Republic.

METHODS: Qualitative and quantitative methods were used. Individual interviews...

Three meetings and fewer funerals–misoprostol in postpartum haemorrhage

Malcolm Potts
Martha Campbell
2004

This commentary article refers to the meeting of theInternational Federation of Gynecology and Obstetrics (FIGO) in Santiago, Chile in 2003, which made reducing post-partum hemorrhage a priority, and two meetings supported by Venture Strategies in May and July 2004 in Kampala, Uganda and Nairobi, Kenya, which took the first steps toward meeting that goal.

Published in Lancet, 9 25 2004, 364(9440):1110-1

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Controlling postpartum hemorrhage after home births in Tanzania

N Prata
G Mbaruku
M Campbell
M Potts
F Vahidnia
2005

This groundbreaking pilot study demonstrates the potential impact of misoprostol for women in rural settings. In this community-based intervention trial, misoprostol was delivered by traditional birth attendants (TBAs) for PPH treatment in rural Kigoma, Tanzania. Results show that TBAs successfully administered misoprostol. Women given misoprostol to treat PPH were far less likely to need additional intervention.

OBJECTIVES: Determine safety of household management of postpartum hemorrhage (PPH) with 1000 microg of rectal misoprostol, and assess possible reduction in referrals and...

A Textbook of Postpartum Hemorrhage: Chapter 19: Overview of Misoprostol Studies in Postpartum Hemorrhage

A Hemmerling
2006

Tables of peer-reviewed misoprostol studies.

The objective of this book is to bring together within a single volume the most up to date information about the epidemiology, diagnosis and management of postpartum hemmorrhage. Whilst much has been published on the subject a truly comprehensive synthesis of this kind has never before been attempted. This volume sets out, therefore, to provide physicians with an overall clinical perspective that has hitherto been unavailable.

Published in A Textbook of Postpartum Hemorrhage, Sapiens Publishing, October 2006, 184-190...

The safety of misoprostol

Anke Hemmerling
2006

Misoprostol is currently on the WHO Essential Drug List for treatment of gastric ulcers, for induced abortion in combination with mifepristone, and more recently for induction of labor. The WHO will review its role as an essential drug for control of postpartum hemorrhage (PPH) in early 2007. Relevant data on the safety of misoprostol has accumulated since the introduction of the drug in the late 1980s. Since then, millions of individuals worldwide have used up to four tablets (800 mcg) daily for treatment and prevention of gastric ulcer.

Published in International Journal of...

Tackling the unacceptable: Nigeria approves misoprostol for postpartum haemorrhage

Amy Jadesimi
Friday E Okonofua
2006

This article discusses the approval of misoprostol in Nigeria for the prevention of postpartum hemorrhage in 2006.

Nigeria has 2% of the world’s population, but 10% of the global burden of maternal deaths – a statistic that is described by Nigeria’s president Olusegun Obasanjo as “unacceptable and must be reversed”. In January 2006, Nigeria took an important step towards reversing this tragic situation when the Nigerian National Agency for Food and Drug Administration and Control approved the distribution of misoprostol for the prevention or treatment of postpartum haemorrhage (PPH...

A Textbook of Postpartum Hemorrhage: Chapter 17: Management of Postpartum Hemorrhage at the Community Level

Ndola Prata
2006

Chapter 17 in A Textbook of Postpartum Hemorrhage discussing Management of Postpartum Hemorrhage at the Community Level

The objective of this book is to bring together within a single volume the most up to date information about the epidemiology, diagnosis and management of postpartum hemorrhage. Whilst much has been published on the subject a truly comprehensive synthesis of this kind has never before been attempted. This volume sets out, therefore, to provide physicians with an overall clinical perspective that has hitherto been unavailable.

The ability to manage postpartum...