TY - JOUR
T1 - Advance distribution of misoprostol for the prevention of postpartum hemorrhage in South Sudan
AU - Smith, Jeffrey M.
AU - Dimiti, Alexander
AU - Dwivedi, Vikas
AU - Ochieng, Isabella
AU - Dalaka, Maryrose
AU - Currie, Sheena
AU - Luka, Edward Eremugo
AU - Rumunu, John
AU - Orero, Solomon
AU - Mungia, Jaime
AU - McKaig, Catharine
N1 - Funding Information:
The authors would like to acknowledge funding provided by the US Agency for International Development .
Publisher Copyright:
© 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Objective: To determine if high uterotonic coverage can be achieved in South Sudan through a facility- and community-focused postpartum hemorrhage (PPH) prevention program.Methods: The program was implemented from October 2012 to March 2013. At health facilities, active management of the third stage of labor (AMTSL) was emphasized. During prenatal care and home visits, misoprostol was distributed to pregnant women at approximately 32 weeks of pregnancy for the prevention of PPH at home births. Data on uterotonic coverage and other program outcomes were collected through facility registers, home visits, and postpartum interviews.Results: In total, 533 home births and 394 facility-based births were reported. Misoprostol was distributed in advance to 787 (84.9%) pregnant women, of whom 652 (82.8%) received the drug during home visits. Among the women who delivered at home, 527 (98.9%) reported taking misoprostol. A uterotonic for PPH prevention was provided at 342 (86.8%) facility-based deliveries. Total uterotonic coverage was 93.7%. No adverse events were reported.Conclusion: It is feasible to achieve high coverage of uterotonic use in a low-resource and postconflict setting with few skilled birth attendants through a combination of advance misoprostol distribution and AMTSL at facilities. Advance distribution through home visits was key to achieving high coverage of misoprostol use.
AB - Objective: To determine if high uterotonic coverage can be achieved in South Sudan through a facility- and community-focused postpartum hemorrhage (PPH) prevention program.Methods: The program was implemented from October 2012 to March 2013. At health facilities, active management of the third stage of labor (AMTSL) was emphasized. During prenatal care and home visits, misoprostol was distributed to pregnant women at approximately 32 weeks of pregnancy for the prevention of PPH at home births. Data on uterotonic coverage and other program outcomes were collected through facility registers, home visits, and postpartum interviews.Results: In total, 533 home births and 394 facility-based births were reported. Misoprostol was distributed in advance to 787 (84.9%) pregnant women, of whom 652 (82.8%) received the drug during home visits. Among the women who delivered at home, 527 (98.9%) reported taking misoprostol. A uterotonic for PPH prevention was provided at 342 (86.8%) facility-based deliveries. Total uterotonic coverage was 93.7%. No adverse events were reported.Conclusion: It is feasible to achieve high coverage of uterotonic use in a low-resource and postconflict setting with few skilled birth attendants through a combination of advance misoprostol distribution and AMTSL at facilities. Advance distribution through home visits was key to achieving high coverage of misoprostol use.
KW - Active management of the third stage of labor
KW - Advance distribution
KW - Community health workers
KW - Coverage
KW - Home birth
KW - Misoprostol
KW - Postpartum hemorrhage prevention
KW - Safety
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U2 - 10.1016/j.ijgo.2014.05.016
DO - 10.1016/j.ijgo.2014.05.016
M3 - Article
C2 - 25051905
AN - SCOPUS:84908077355
SN - 0020-7292
VL - 127
SP - 183
EP - 188
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 2
ER -