印度可获取药物流产药品的景观评估。

Landscape assessment of the availability of medical abortion medicines in India.

机构信息

World Health Organization, Country Office for India, New Delhi, India.

Department of Obstetrics and Gynecology, All India Institute of Medical Science (AIIMS), New Delhi, India.

出版信息

Reprod Health. 2024 Jun 5;20(Suppl 1):193. doi: 10.1186/s12978-024-01774-5.

DOI:10.1186/s12978-024-01774-5

PMID:38840263

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11151496/

Abstract

BACKGROUND

Medical abortion with mifepristone and misoprostol can be provided up to 63 days' gestation in India. This accounts for 67.5 percent of all abortions in the country. We conducted an assessment to determine the availability of medical abortion medicines, specifically the combi-pack, in India.

METHODS

We applied the World Health Organization landscape assessment protocol at the national level. The assessment protocol included a five-step adaptation of an existing availability framework, including online data collection, desk review, country-level key informant interviews, and an analysis to identify barriers and opportunities to improve medical abortion availability. The assessment was conducted between August and March 2021.

RESULTS

Medicines for medical abortion are included in the national essential drug list and available with prescription in India. The assessment identified 42 combi-pack products developed by 35 manufacturers. The quality of medical abortion medicines is regulated by national authorities; but as health is devolved to states, there are significant inter-state variations. This is seen across financing, procurement, manufacturing, and monitoring mechanisms for quality assurance of medical abortion medicines prior to distribution. There is a need to strengthen supply chain systems, ensure consistent availability of trained providers and build community awareness on use of medical abortion medicines for early abortions, at the time of the assessment.

CONCLUSION

Opportunities to improve availability and quality of medical abortion medicines exist. For example, uniform implementation of regulatory standards, greater emphasis on quality-assurance during manufacturing, and standardizing of procurement and supply chain systems across states. Regular in-service training of providers on medical abortion is required. Finally, innovations in evidence dissemination and community engagement about the recently amended abortion law are needed.

摘要

背景

在印度，米非司酮和米索前列醇药物流产可用于妊娠 63 天以内的情况，占该国所有堕胎的 67.5%。我们对印度米非司酮和米索前列醇药物流产的供应情况进行了评估。

方法

我们在国家层面应用了世界卫生组织的景观评估方案。评估方案包括对现有供应框架进行五步改编，包括在线数据收集、文献回顾、国家一级关键知情人访谈以及分析以确定改善药物流产供应的障碍和机会。评估于 2021 年 8 月至 3 月进行。

结果

印度国家基本药物清单中包含药物流产药物，凭处方即可获得。评估确定了 35 家制造商生产的 42 种组合包装产品。国家当局对药物流产药物的质量进行监管；但由于卫生权下放给各州，各州之间存在显著差异。这体现在药物流产药物质量保证的融资、采购、制造和监测机制之前。需要加强供应链系统，确保有足够的经过培训的提供者，并在评估时提高社区对早期堕胎中使用药物流产药物的认识。