| Women in Rufiji benefit from misoprostol | Send to a friend |
| Sunday, 27 March 2011 06:22 |
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In Tanzania, more than half of deliveries take place at home, although 94 per cent of women receive antenatal care (ANC)—medical supervision given to pregnant women and their babies starting from the time of conception up to the delivery. One method currently in application to help reduce maternal and child deaths associated with unsafe home deliveries is the use of misoprostol, a tablet deemed effective in stopping post-delivery bleeding. Research findings have established that the drug can reduce maternal mortality rates from 454 to 300 per 100,000 live births; and many women who have used it commend its efficacy. Aziza Mohamed, 25, a resident of Rufiji in Coast Region is one of them. She says she has found the tablet beneficial as it helped her stop the heavy bleeding she used to undergo during delivery. Recently, when her labour started at 2 in the morning, she was taken with a bicycle to a neighbouring hospital. It was her second pregnancy. The childbirth was accompanied by heavy bleeding and she was given the tablet. “Miso helped me reduce the heavy bleeding and I was healthy after delivery,” she testifies. When she delivered her first baby in 2007 and also suffered from severe bleeding, she was given an injection to stop the haemorrhage. Comparing the two incidents, she says that the use of the tablet was much better than the injection. She learned about misoprostol when attending antenatal care at the clinic, where medical experts recommended to the expecting mothers to use the drug to avert bleeding during delivery at home. “I advise pregnant women to attend antenatal care so as to have the tablets in hand in case of emergency,” she says. And Zuhura Khalifa, 19, also confirms that the tablet has helped her to avert blood loss during child birth. Zuhura, who also attended antenatal care, says she is happy that her safety when delivering, even if she delays to reach the hospital, is now more certain. And according to the research, the acceptability of misoprostol among women has been increasing as time The remarkable milestone is a brainchild of a project by the Ifakara Health Institute (IHI) under which health practitioners in Rufiji District were trained on how to use misoprostol tablets to reduce excessive bleeding during child delivery. Health practitioners involved in the project included those providing antenatal care services to women. Vailet Karatwa, a nurse at Kibiti hospital in Rufiji was among those who attended the training in 2008, through a joint initiative by IHI and Venture Strategies Innovations (VSI), whose goal was to save lives by preventing post-partum haemorrhage (PPH) –excessive bleeding after birth--with application of misoprostol drug at home. The aim was to reach women who were unable to reach a health facility to deliver. Overall, the project has now been carried out in four districts in Tanzania--Kigoma Urban, Kilombero, Ulanga and Rufiji. By mid of January 2009, the project staff in all the four districts trained included antenatal care providers, research assistants, community resource persons, community supervisors, traditional birth attendants (TBA) and TBA supervisors. “We were taught on how to disseminate the tablet, who to give, and at what time,” she says. Women 32 weeks or more in pregnancy were given the tablets to have them in case of delivery out of the hospital. In Rufiji almost all women who were given the pills accepted them. “Women were taking the tablets with their own consent after training them on how to use it. We were glad that they were cooperative. But women under 18 years old were not allowed to use the pills, and they where many of them,” Vailet says. According to her, many women in the rural areas deliver at home because they fail to get to hospital in time due to various reasons, including lack of transport. “For them having the tablets has been an effective way to help prevent deaths resulting from child births when they delay reaching the hospital,” she says. Easy to use Misoprostol is said to prevent postpartum haemorrhage (excessive bleeding after birth), which contributes up to 34 per cent of maternal deaths in the country. The tablet has been approved for use in the prevention and treatment of PPH since September 2007 in Tanzania. Before the tablet, Vailet says health practitioners were using oxytoxin, which is given in injections. However, a major challenge with the injection is that it has to be kept in a refrigerated condition, which is a hurdle in the rural areas. “We keep the oxytoxin at the general laboratory since we have the fridge in the delivery ward. But the distance of transferring the injections from the laboratory to the villages makes the temperature alter, and thus affects its effectiveness,’ she says, adding that electricity shortage is also a big challenge on its wider application. In contrast, it easier for the health officials to administer misoprostol, which is a tablet. “I find misoprostol more effective than the injections because it is easy to store. For me, I prefer giving a woman misoprostol after delivery than an injection, because it is more effective,” says the nurse. The Mama packs Dr Albert Kitumbo, project manager of the programme, says that before the application of misoprostol PPH was claiming lives of many women, but now the rates have been reduced significantly. He advises women who attend antenatal care to be role models to others by advising them to attend clinics and to convince them on the benefits of the pill. Recently, the government approved the findings of the research and decided start a country-wide programme to include the misoprostol drug in ‘Mama packs’ given to mothers during antenatal clinic visits. “In order to save mothers’ lives, we have asked the government to reduce the time for distributing the drug, which was on 32 weeks of pregnancy, because at that stage some women do not visit the clinic. We also recommended a review of the age limit (currently above 18), since younger women also suffer from PPH),” notes Dr Kitumbo. However, there has also been a lingering controversy that the same pill is used to induce early abortion. Commenting on this, Kitumbo says education to the public should be provided on the recommended use of the pill, and policies be put in place to tackle its misuse. Add this page to your favorite Social Bookmarking websites           |
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