Advance distribution of misoprostol for prevention of postpartum hemorrhage at home births in two districts of Liberia

Publish Date: June 2014
Author: Jeffrey Michael Smith, Saye Dahn Baawo, Marion Subah, Varwo Sirtor-Gbassie, Cuallau Jabbeh Howe, Gbenga Ishola, Bentoe Z Tehoungue, Vikas Dwivedi
Language: English

BMC Pregnancy and Childbirth has published the MCHIP co-authored article “Advance distribution of misoprostol for prevention of postpartum hemorrhage (PPH) at home births in two districts of Liberia” describing the results of a learning phase program on the feasibility, acceptability and program effectiveness of a PPH prevention program for home and facility births in two districts of Liberia.

The program sought to achieve high coverage of use of a uterotonic immediately after birth for all births. Advance distribution of misoprostol was offered by health workers during antenatal care (ANC) at eight facilities and by the District Reproductive Health Supervisors during home visits. Distribution through the Trained Traditional Midwives was not permitted in this program.

Of the estimated deliveries during the implementation period, 53.7% were enrolled and provided misoprostol, primarily through ANC (78.2%). Uterotonic coverage rate of all deliveries was 53.5%, based on 97.7% oxytocin use at facility births and 24.9% misoprostol use at home births. Among 550 women interviewed postpartum, 87.7% of those who received misoprostol and had a home birth took the drug. No serious adverse events were reported among enrolled women, and facility-based deliveries appeared to increase during the program. Effectiveness of the program was limited by restricting distribution to only health care workers. A revised community-based strategy is needed to increase advance distribution rates and misoprostol coverage rates for home births.

To read the open access article, click here.