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Safe Birth Africa

Misoprostol to Prevent Postpartum Hemorrhaging

Health Systems 20/20 conducted a Safe Birth Africa activity in Senegal to evaluate the use of Misoprostol (Cytotec®, a synthetic analog of prostaglandin) to prevent post-partum hemorrhaging (PPH) at the community level.

The Safe Birth Africa Initiative was launched in early 2006 by USAID’s Maternal Health team, Global Health Bureau, and Africa Bureau to focus on active management of the third stage of labor and essential newborn care. In Senegal, Health Systems 20/20 collaborated with the Ministry of Health (MOH) Department of Reproductive Health, the Centre de Formation et de Recherche en Santé de la Reproduction (CEFOREP), IntraHealth, and the Christian Children’s Fund. Policy issues included adding Misoprostol to the MOH drug list for gynecological uses and allowing the introduction of the drug for prevention of PPH at the community level.

Final results from the study carried out in the rural districts of Thies and Kaolack show that the matronnes, (under the supervision of a more qualified health provider in this study), administered Misoprostol correctly 100 percent of the time. This was after receiving only one day of Misoprostol-specific practical training. Moreover, most of the women who received Misoprostol indicated that they would be willing to pay something for the drug. However, further efforts will be needed to convince policymakers in Senegal to support a formal change in policy that would authorize matronnes to administer Misoprostol to treat or prevent PPH, to facilitate importation of Misoprostol for gynecological uses, and to increase its acceptance by medical professionals.