March 22, 2011

Tanzania and Kenya demonstrate misoprostol distribution at ANC protects mothers from PPH, plan for program expansion

(NAIROBI, KENYA) – In March 2011, VSI, the Ministry of Health and local partners from Tanzania and Kenya disseminated the results of projects in each country assessing the feasibility of distribution of misoprostol directly to women while pregnant to increase protection from life-threatening bleeding after childbirth, or postpartum hemorrhage (PPH). With high attendance at antenatal care (ANC) (96% in Tanzania and 92% in Kenya) but more than half of deliveries taking place at home, the partners capitalized on ANC as an opportunity to reach women with misoprostol and safer childbirth education in case they were unable to deliver in a facility.

In collaboration with VSI, PSI, the Bixby Center for Population, Health and Sustainability at the University of California, Berkeley and the Ministry of Health and Social Welfare (MOHSW), the Ifakara Health Institute introduced misoprostol at ANC visits in four Tanzanian districts (Kigoma Urban, Kilombero, Rufiji and Ulanga) from January 2009 to January 2010. Over the course of the project, over 12,000 women were educated on PPH, misoprostol and the importance of delivering in a health facility when they attended ANC. Eligible women received misoprostol tablets after 32 weeks gestation.

The Tanzania project proved successful in reaching women with the campaign messages as well as in increasing protection against PPH by using a uterotonic drug. Eighty-eight percent of women who delivered at home in the project took misoprostol for PPH prevention, and 92% of facility deliveries benefited from either an injection or misoprostol for PPH prevention. Nearly all women used the tablets correctly at home births. For more on the project results, read the final results in brief.

On the occasion of the dissemination meeting of the Tanzania research in Dar es Salaam, the MOHSW voiced support for scaling up the intervention throughout the country. In a speech on behalf of the Permanent Secretary, Mrs. Blandia S. J. Nyoni, Dr. Donan Mmbando said, “The MOH is fully committed in this endeavor as one of our efforts to achieve the Millennium Development Goals.”

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In Kenya, where VSI worked in collaboration with the Kenya Obstetrical and Gynaecological Society and the Ministry of Public Health and Sanitation (MOPHS), women received education and misoprostol tablets at ANC regardless of gestational age in two districts (Kitui and Maragua). In addition, the project utilized skilled retired community midwives in Maragua District, equipping them with misoprostol tablets so they could ensure women had protection against PPH at delivery.

Results in Kenya similarly demonstrated the effectiveness of misoprostol distribution through these channels. The vast majority of women used misoprostol correctly at delivery (97%) and the introduction of misoprostol translated to 95% of home births in both districts being protected from PPH with misoprostol, births that otherwise would have received nothing. More results are available here.

Project participants and beneficiaries shared their experiences with government and NGO stakeholders at the dissemination meeting in Nairobi, including Jacinta, a community midwife, who said,

“We midwives may be retired, but we aren’t tired. All we want is to have the tools to care for the mothers in our communities.”

Following the dissemination of the results, the MOPHS appointed a task force to develop a plan to implement the meeting recommendations, including the development of extensive guidelines for the use of misoprostol throughout the country.

In both Tanzania and Kenya, misoprostol is registered for the prevention and treatment of PPH as well as for the treatment of incomplete abortion, another life-saving use of the drug.

Related news coverage:

Tanzania

The Citizen, March 27, 2011, "Women in Rufiji benefit from misoprostol" (Tanzania)
The Guardian, March 4, 2011, "Ministry promises wide distribution of new drug" (Tanzania)
The Guardian, March 3, 2011, "New drug boosts safe motherhood"(Tanzania)

Kenya

The Standard, March 23, 2011, "Pill stops mothers from bleeding to death after birth" (Kenya)
Coastweek, March 18, 2011, "New drug and treatment to curb maternal deaths" (Kenya)

Photo Credit: ©2011 Sameer Kermalli - VSI

To read the full results from the Tanzania project,
click here.

To read the full results from the Kenya project,
click here.

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