Reproductive Health

Introducing Misoprostol for the Management of Postpartum Hemorrhage in Zimbabwe


The Zimbabwe Ministry of Health and Child Care and VSI conducted an operations research to address maternal deaths associated with postpartum hemorrhage (PPH). This brief provides strong evidence that introducing misoprostol as an alternative uterotonic when oxytocin is not available can effectively expand uterotonic coverage to women delivering in health facilities.

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Training traditional birth attendants on the use of misoprostol and a blood measurement tool to prevent postpartum haemorrhage: lessons learnt from Bangladesh

Ndola Prata
Suzanne Bell
Paige Passano
Daniel Bohl
Arshadul Islam

A consensus emerged in the late 1990s among leaders in global maternal health that traditional birth attendants (TBAs) should no longer be trained in delivery skills and should instead be trained as promoters of facility-based care. Many TBAs continue to be trained in places where home deliveries are the norm and the potential impacts of this training are important to understand. The primary objective of this study was to gain a more nuanced understanding of the full impact of training TBAs to use misoprostol and a blood measurement tool (mat) for the prevention of postpartum...

Assessing political priority for reproductive health in Ethiopia

Ndola Prata
Anna Summer

Ethiopia is among the top six countries contributing to the highest numbers of maternal deaths globally. The Ethiopian total fertility rate was estimated at 4.8 in 2011, and the use of contraceptives by married women was 29%. Lack of knowledge, cultural stigma surrounding abortion, and barriers to access of services contribute to persistently high rates of unsafe abortion and abortion-related mortality. This study seeks to assess the generation and institutionalization of political priority for reproductive health within the political systems of Ethiopia. Interviews with key policy makers...

Is attendant at delivery associated with the use of interventions to prevent postpartum hemorrhage at home births? The case of Bangladesh

Ndola Prata
Suzanne Bell
Martine Holston
Mohammad A Quaiyum

Hemorrhage is the leading cause of maternal mortality in Bangladesh, the majority of which is due to postpartum hemorrhage (PPH), blood loss of 500 mL or more. Many deaths due to PPH occur at home where approximately 77% of births take place. This paper aims to determine whether the attendant at home delivery (i.e. traditional birth attendant (TBA) trained on PPH interventions, TBA not trained on interventions, or lay attendant) is associated with the use of interventions to prevent PPH at home births.

Methods: Data come from operations research to determine the safety...

Establishing a Referral System for Safe and Legal Abortion Care: A Pilot Project on the Thailand-Burma Border

Meredith Walsh
Angel M. Foster
Grady Arnott
Margaret Hobstetter
Htin Zaw
Cynthia Maung
Cari Sietstra

Women from Burma living in Thailand are generally unable to access safe abortion care—even for cases that clearly fall within the legal exceptions—because of a lack of knowledge of the Thai medical and legal systems, restrictions on travel and movement, the costs associated with the procedure, a dearth of culturally and linguistically compatible providers, and stigma. As a consequence, women from Burma on both sides of the border suffer significant reproductive health morbidities as a result of unsafe abortion. This context motivated the pilot project described in this report. We...

Engaging Men in Family Planning: Perspectives From Married Men in Lomé, Togo

Ndola Prata
Tekou B. Koffi
Karen Weidert
Erakalaza Ouro Bitasse
Marthe Adjoko E
Mensah, Jacques Emina
Sheila Mensah
Annette Bongiovanni

Family planning programs have made vast progress in many regions of sub-Saharan Africa in the last decade, but francophone West Africa is still lagging behind. More emphasis on male engagement might result in better outcomes, especially in countries with strong patriarchal societies. Few studies in francophone West Africa have examined attitudes of male involvement in family planning from the perspective of men themselves, yet this evidence is necessary for development of successful family planning projects that include men. This qualitative study, conducted in 2016, explored...

Abortion history and its association with current use of modern contraceptive methods in Luanda, Angola

Ndola Prata
Natalie Morris

The Bixby Center’s Natalie Morris and Ndola Prata have published an article in the Open Access Journal of Contraception on their study regarding abortion’s influence on contraceptive behavior in Luanda, Angola.

Background: Women in sub-Saharan Africa often use abortion as a method of limiting their fertility and spacing births. However, it is not well understood whether having an abortion influences contraceptive behavior. The goal of this study was to examine associations between abortion history and use of a modern contraceptive method among women in Luanda,...