Programmes for advance distribution of misoprostol to prevent post-partum haemorrhage: a rapid literature review of factors affecting implementation

Health Policy and Planning
Helen J SmithA Metin Gülmezoglu

Abstract

Recent efforts to prevent post-partum haemorrhage (PPH) in low-income countries have focused on providing women with access to oral misoprostol during home birth. The WHO recommends using lay health workers (LHWs) to administer misoprostol in settings where skilled birth attendants are not available. This review synthesizes current knowledge about the barriers and facilitators affecting implementation of advance community distribution of misoprostol to prevent PPH, where misoprostol may be self-administered or administered by an LHW.We searched for and summarized available empirical evidence, and collected primary data from programme stakeholders about their experiences of programme implementation.We present key outcomes and features of advanced distribution programmes that are in operation or have been piloted globally. We categorized factors influencing implementation into those that operate at the health system level, factors related to the community and policy context and those factors more closely connected to the end user.Debates around advance distribution have centred on the potential risks and benefits of making misoprostol available to pregnant women and community members during pregnancy for administration in the hom...Continue Reading

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Citations

May 10, 2016·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Elisa WellsSenait Tibebu
Feb 8, 2018·BMC Pregnancy and Childbirth·Tessa M RaamsMarcus J Rijken
Nov 7, 2019·BMC Pregnancy and Childbirth·Gizachew Tadele TirunehYibeltal Tebekaw Bayou
Sep 1, 2017·BMC Pregnancy and Childbirth·Andrea Solnes MiltenburgHelen Smith

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