Achieving Sustainable Development Goal targets for 2030 will requirepersistent investment and creativity in improving access to quality healthservices, including skilled attendance at birth and access to emergencyobstetric care. Community-based misoprostol has been extensivelystudied and recently endorsed by the WHO for the prevention of post-partum haemorrhage. There remains little consolidated information aboutexperience with implementation and scale-up to date. This narrativereview of the literature aimed to identify the political processes leading toWHO endorsement of misoprostol for...
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.
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.
Mozambique has high maternal mortality which is compounded by limited human resources for health, weak access to health services, and poor development indicators. In 2011, the Mozambique Ministry of Health (MoH) approved the distribution of misoprostol for the prevention of post-partum haemorrhage (PPH) at home births where oxytocin is not available. Misoprostol can be administered by a traditional birth attendant or self-administered. The objective of this paper is to examine, through applying a human rights lens, the broader contextual, policy and institutional issues that...
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.
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
