Abstract
Objective: To determine feasibility of community-based distribution of misoprostol for preventing postpartum hemorrhage (PPH) to pregnant woman through community volunteers working under government health services. Methods: Implemented in one district in Nepal. The primary measure of performance was uterotonic protection after childbirth, measured using pre- and postintervention surveys (28 clusters, each with 30 households). Maternal deaths were ascertained through systematic health facility and community-based surveillance; causes of death were assigned based on verbal autopsy. Results: Of 840 postintervention survey respondents, 73.2% received misoprostol. The standardized proportion of vaginal deliveries protected by a uterotonic rose from 11.6% to 74.2%. Those experiencing the largest gains were the poor, the illiterate, and those living in remote areas. Conclusion: Community-based distribution of misoprostol for PPH prevention can be successfully implemented under government health services in a low-resource, geographically challenging setting, resulting in much increased population-level protection against PPH, with particularly large gains among the disadvantaged.
Original language | English (US) |
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Pages (from-to) | 282-288 |
Number of pages | 7 |
Journal | International Journal of Gynecology and Obstetrics |
Volume | 108 |
Issue number | 3 |
DOIs | |
State | Published - Mar 2010 |
Keywords
- Community-based distribution
- Misoprostol
- Nepal
- Operations research
- Postpartum hemorrhage
- Self-administration
ASJC Scopus subject areas
- Obstetrics and Gynecology