Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL, USA; Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL, USA.
BJOG. 2014 Feb;121(3):319-25. doi: 10.1111/1471-0528.12447. Epub 2013 Nov 28.
To report on a rigorous distribution and monitoring plan to track misoprostol for community-based distribution to reduce postpartum haemorrhage (PPH) in rural Ghana.
Operations research.
Rural Ghana.
Women in third trimester of pregnancy presenting to primary health centres (PHCs) for antenatal care (ANC).
Ghana Health Service (GHS), Millennium Village Projects, and the University of Illinois at Chicago conducted an operations research study designed to assess the safety, feasibility, and acceptability of community-based distribution of misoprostol to prevent PPH at home deliveries in rural Ghana. One thousand doses (3000 tablets, 200 μg each) were obtained from the Family Health Division of GHS. Three 200-μg tablets of misoprostol (600 μg) in foil packets were packaged together in secured transparent plastic packets labelled with pictorial messages and distributed to midwives at seven PHCs for distribution to pregnant women.
Correct use of misoprostol in home deliveries and retrieval of unused misoprostol doses, PPH rates and maternal mortality.
Of the 999 doses distributed to midwives, 982 (98.3%) were successfully tracked, with a 1.7% lost to follow-up rate. Midwives distributed 654 doses to women at third-trimester ANC visits. Of women who had misoprostol to use at home, 81% had an institutional delivery and were able to return the misoprostol safely to the midwife. Of the women that used misoprostol, 99% used the misoprostol correctly.
This study clearly demonstrates that misoprostol distributed antenatally to pregnant women can be used accurately and reliably by rural Ghanaian women, and should be considered for policy implementation across Ghana and other countries with high home birth rates and maternal mortality ratios.
报告一项严格的分发和监测计划，以跟踪米索前列醇在社区的分发情况，以减少加纳农村地区的产后出血（PPH）。
运营研究。
加纳农村。
在初级卫生中心（PHC）接受产前保健（ANC）的妊娠晚期妇女。
加纳卫生服务局（GHS）、千年村项目和伊利诺伊大学芝加哥分校开展了一项运营研究，旨在评估在加纳农村地区，将米索前列醇在社区分发用于预防家庭分娩中 PPH 的安全性、可行性和可接受性。从 GHS 的家庭健康司获得了 1000 剂（3000 片，每片 200μg）米索前列醇。将 3 片 200μg 的米索前列醇（600μg）包装在箔袋中，放在安全透明的塑料袋中，贴上带有图画信息的标签，分发给 7 个 PHC 的助产士，以供分发给孕妇。
家庭分娩中米索前列醇的正确使用和未使用米索前列醇剂量的回收、PPH 发生率和孕产妇死亡率。
在分发给助产士的 999 剂中，成功跟踪了 982 剂（98.3%），失访率为 1.7%。助产士向第三孕期 ANC 就诊的妇女分发了 654 剂。在家分娩时使用米索前列醇的妇女中，81%在机构分娩，能够安全地将米索前列醇归还给助产士。在使用米索前列醇的妇女中，99%正确使用了米索前列醇。
这项研究清楚地表明，在加纳农村地区，产前分发给孕妇的米索前列醇可以被加纳农村妇女准确、可靠地使用，应该考虑在加纳和其他高家庭分娩率和孕产妇死亡率的国家实施该政策。
