Assessing Society for Family Health's Misoprostol Pilot Project for the Prevention of Postpartum Hemorrhage in Rural Zambia

Purpose: Evaluate programs to prevent post partum hemorrhage (PPH) in rural settings where access to trained health personnel, health facilities and oxytocin are limited and rates of home delivery high. Data used: Results of in-depth interviews with rural women who used Misoprostol for PPH prevention, or who assisted home deliveries following which Misoprostol was used. Methods: Interviewed 36 purposively sampled women aged 18-49 who had used Misoprostol following a delivery at home or at a health facility. Data collectors interviewed women at health facilities where interviewees were seeking routine child health services. Story narratives where used to collect the data. Results: Results suggest that; antenatal care is an appropriate channel for distribution and promotion of Misoprostol where access to oxytocin is limited and rates of home-deliveries high. In addition, Trained TBAs are an effective channel to reinforce access to Misoprostol and related safe delivery messages. Advance distribution of Misoprostol (to pregnant women) does not have a negative influence on plans to delivery at a facility. Recommendations: Future PPH prevention programs in similar rural settings should: • Incorporate testimonials from women who used Misoprostol, to motivate others to develop and implement a safe delivery plan—including, where appropriate, correct use of Misoprostol. • Promote Misoprostol within the context of broader safe delivery programming. • Develop communications to address myths and misconceptions regarding Misoprostol. • Develop a pre-packaged individual dose Misoprostol product for PPH prevention. • Expand efforts to distribute Misoprostol and information on PPH prevention)to pregnant women through antenatal care.