Community-based distribution of misoprostol for prevention of postpartum hemorrhage (PPH) in resource-poor settings has been shown to be safe and effective. However, global recommendations for prenatal distribution and monitoring within a community setting are not yet available. In order to successfully translate misoprostol and PPH research into policy and practice, several critical points must be considered. A focus on engaging the community, emphasizing the safe nature of community-based misoprostol distribution, supply chain management, effective distribution, coverage, and monitoring plans are essential elements to community-based misoprostol program introduction, expansion, or scale-up.
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http://dx.doi.org/10.1016/j.ijgo.2013.12.005 | DOI Listing |
Int J MCH AIDS
September 2024
Global Resources for Health West and Central Africa & Country Programs Nigeria, Clinton Health Access Initiative, Maitama, Abuja, Nigeria.
Background And Objective: The burden of maternal mortality attributable to postpartum hemorrhage (PPH) remains high in Nigeria. Currently, oxytocin, and misoprostol, which are largely of suboptimal quality, are used for PPH prevention and treatment. Heat-stable carbetocin (HSC) is a viable uterotonic option for PPH prevention in a setting like Nigeria where compromised supply and cold chain systems result in the preponderance of poor-quality oxytocin and suboptimal PPH management.
View Article and Find Full Text PDFContraception
April 2024
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, United States. Electronic address:
Objectives: This an exploratory study aimed to describe methods and outcomes of comprehensive community-led abortion care in the United States and Canada.
Study Design: This community-based participatory research study recruited community abortion providers from the United States and Canada through existing confidential networks. They participated through in-person and online collaboration to design and implement a data collection tool for abortion methods, outcomes, and motivations from clients.
BMC Public Health
December 2023
Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada.
Background: Ongoing high neonatal mortality rates (NMRs) represent a global challenge. In 2021, of the 5 million deaths reported worldwide for children under five years of age, 47% were newborns. Pakistan has one of the five highest national NMRs in the world, with an estimated 39 neonatal deaths per 1,000 live births.
View Article and Find Full Text PDFReprod Health
September 2022
Population Council, New York, USA.
Background: Discussions around quality of abortion care have been focused mainly on service-delivery aspects inside healthcare facilities. More recently, with availability of medical abortion (MA), increase in its self-use, and emergence of other delivery platforms such as telemedicine, the responsibility of quality care has broadened to actors outside of facilities.
Body Of Text: This commentary discusses the meaning of quality of abortion care with the paradigm shift brought by medical and technological advancement in abortions, and raises questions on the role of the state in ensuring quality in abortion management-especially in settings where abortion is decriminalized, but also in countries where abortion is permitted under certain circumstances.
Contraception
May 2022
Peace Foundation, Sindh, Pakistan.
Objective: To evaluate the outcomes of a community-based distribution program in which lay providers offer women in Sindh, Pakistan misoprostol for early abortion.
Study Design: We reviewed monitoring logbooks to examine pregnancy outcomes and analyzed logbook data using descriptive statistics.
Results: In late 2019, 120 women obtained abortion care through this program.
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