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Long-Term Community Use of Misoprostol Kigoma , Tanzania

Long-Term Community Use of Misoprostol Kigoma , Tanzania. Ndola Prata University of California, Berkeley Venture Strategies for Health and Development. 1. Long-Term Community Use of Misoprostol Study. Evaluate the long-term use of misoprostol to treat PPH during home births, including:

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Long-Term Community Use of Misoprostol Kigoma , Tanzania

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  1. Long-Term Community Use of MisoprostolKigoma, Tanzania Ndola Prata University of California, Berkeley Venture Strategies for Health and Development 1

  2. 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 2

  3. Interviewers Meeting the TBAs

  4. 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 Qualitative data

  5. Knowledge of PPH and Misoprostol 6

  6. Sources of Misoprostol Information

  7. Measurement of Bleeding

  8. Use of Misoprostol among TBA assisted deliveries Women with perceived PPH (N=201) Women offered misoprostol (N=171) 85% Women accepted misoprostol (N=151) 88% Women who took misoprostol and needed to be transferred for additional interventions (N=3) 2%

  9. Side Effects among those who took misoprostol (n=161)

  10. Referrals 23

  11. Acceptability

  12. “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 13

  13. Willingness to Pay for Misoprostol

  14. Willingness to pay for Misoprostol

  15. 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

  16. Acknowledgements Maweni Hospital, Kigoma, Tanzania Funding & commodities procurement: Technical assistance: Bixby Program in Population, Family Planning & Maternal Health University of California, Berkeley 17

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