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...
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.
Conflicts between male and female reproductive agendas continue to play out in contemporary issues of sex, power, and politics. Viewing gender through the lens of biologic evolutionary psychology reveals persistent con- troversies surrounding women’s rights. The history of oral contraceptives com- pared with that of erectile dysfunction drugs is just one example of the disparity between female and male reproductive choices. Contraceptives, maternal mortality, abortion, and domestic violence are issues directly influenced by politics, religion, and gender biases. Ultimately, everything that...
High maternal morbidity and mortality in many developing countries are highly associated with poor access to and quality of health care. Here we review the economic feasibility of the WHO’s mother-baby package as a means of reducing maternal and neonatal mortality and morbidity in Tanzania. This paper examines the costs of maternal health care in Tanzania, and how much can we expect households to contribute to these expenses, if the MBP were implemented. Using data from the Tanzanian 1993 Living Standard Measurement Survey (LSMS), we analyze responses from 757 women of reproductive age who...
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...
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...
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.
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...
In rural African settings, the colorful fabric kanga is locally-made and inexpensive; every woman owns dozens for use as skirts and shawls. The kanga has become useful as a simple solution for the complicated problem of measuring blood loss after delivery. This commentary describes remarkable results when traditional birth attendants in Tanzania use the kanga to identify postpartum hemorrhage.
Published in International Journal of Gynecology and Obstetrics (2005) 89, 49—50
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.
