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199365 Using Misoprostol to improve access to PAC/Safe abortion in low resource settingMonday, November 9, 2009: 3:10 PM
Objective. The objective of this pilot project is to contribute to the reduction of maternal mortality and morbidity in western Kenya by implementing Misoprostol as an alternative method for safe uterine evacuation.
Description of the Project: 10 private PAC Network providers (physicians and midwives) in three provinces (Nyanza, Rift Valley and Western) underwent training in the use of Misoprostol and supplied with Misoprostols. In addition a protocol on standards & guidelines was developed for use. Between October 2007 and July 2008, 437 clients were served at 7 provider sites with a success rate of 90.27% with the first dose of misoprostol. And Midwives served 77% of the clients. Lessons Learned: Misoprostol is a safe and effective alternative to surgical uterine evacuation methods. Providers have reported that it is “cheap and safe”, and that women prefer it to a traditional surgical method as it is more natural and mimics a natural miscarriage. Policy and Programme Implications: Medication uterine evacuation offers an attractive alternative to traditional surgical methods for safe abortion and post-abortion care. It has particular benefits in low-resource settings because it is cheap and does not required highly skilled providers, and has been shown to be highly effective and safe for uterine evacuation. Based on the success of our pilot project, KMET believes that the use of Misoprostol alone should be expanded to improve access in choices and services to more women, and become an essential tool in post-abortion care programs.
Learning Objectives: Keywords: Abortion, Access and Services
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: Ms. Oguttu directs K-MET project, a Reproductive Health project that trains a Network of health Providers to expand access for comprehensive Reproductive Health services to the rural and hard to reach communities in Kenya. Through this initiative to make the services accessible the providers have been linked with the trained community based health workers to create demand for the RH services.
Trained as a midwife she has been working towards improving Post Abortion Care (PAC) services to women through midlevel providers. She also serves as a Master Trainer in Emergency obstetric care in Africa Region. She has been involved in both curriculum development and training PAC providers from Sudan, Zimbabwe, Cameroon, Eritrea, Tanzania and Uganda.
She has worked as a Reproductive Health consultant in many organizations both locally and internationally. In 2000, in collaboration with Ipas, she organized and facilitated the field-testing of the WHO training module for Nurse/Midwives on managing incomplete Abortion using the KMET PAC provider Network.
Prior to the current post, she managed a busy Maternity unit at Kenyatta National Teaching and Referral Hospital doubling as an Honorary Lecturer at the dept. of Advanced Nursing – Nairobi University.
As a member of The Kenya Prevention of Maternal Mortality team, has done a lot of research on the contributing factors to maternal mortality and morbidity in the districts with the highest maternal deaths in Kenya.
Through her dedication and commitment she made Kenya proud by bringing the Prestigious Margaret Sanger Award to the country in April 2005 and 2006.
Monica is currently pursuing her doctrine degree at the university of Central England (UCE) through distant
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
See more of: Abortion from the clinician's perspective
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