LongTerm Community Use of Misoprostol Kigoma, Tanzania

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Long-Term Community Use of MisoprostolKigoma,
Tanzania

• Ndola Prata
• University of California, Berkeley
• Venture Strategies for Health and Development

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Long-Term Community Use of Misoprostol Study

• Evaluate the long-term use of misoprostol to
  treat PPH during home births, including
• Exposure comprehension of PPH Miso
• Use, safety and acceptability of misoprostol
• Willingness to pay for misoprostol

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Interviewers Meeting the TBAs
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Qualitative data

• 32 In-Depth Interviews
• Mothers 19
• TBAs 7
• Health Providers 5
• Focus Groups
• Community Leaders (Intervention and
  non-Intervention)
• TBAs (Intervention and non-Intervention)
• Health Providers
• Review of facility data on referrals and adverse
  events
• Review of community registry of maternal deaths

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Knowledge of PPH and Misoprostol
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Sources of Misoprostol Information
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Measurement of Bleeding
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Use of Misoprostol among TBA assisted deliveries
Women with perceived PPH (N201)
Women offered misoprostol (N171) 85
Women accepted misoprostol (N151) 88
Women who took misoprostol and needed to be
transferred for additional interventions (N3) 2
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Side Effects among those who took misoprostol
(n161)
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Referrals
23
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Acceptability
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• Bring more! Bring more tablets!
• Response of a mother after the interviewer
  introduced himself as part of a misoprostol study
• Field Notes, Martine Holston Research Assistant

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Willingness to Pay for Misoprostol
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Willingness to pay for Misoprostol
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Lessons from the field

• No indication of misuse
• No evidence of increased morbidity/mortality
• No evidence of increased home deliveries
• Kanga continues to be used as a tool for
  referral and drug administration
• Miso can effectively and safely be administered
  by CHW trained in its use
• Women remember PPH miso messages
• High level of acceptability and WTP
• Subsidies might be needed
• ANC untapped resource for PPH miso information

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Acknowledgements

• Maweni Hospital, Kigoma, Tanzania
• Funding commodities procurement
• Technical assistance

Bixby Program in Population, Family Planning
Maternal Health University of California,
Berkeley
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