Provider Knowledge of and Preference for misoprostol for postabortion care in Tanzania

Every year, approximately 2 million unsafe abortions occur in East Africa, and consequently, many women need treatment for complications associated with incomplete abortion. In Tanzania, where abortion is highly restricted, unsafe abortions contribute to 1/3 of maternal deaths. Misoprostol, a tablet that can be easily stored and administered, is an essential treatment for incomplete abortion, a key component of postabortion care (PAC). We surveyed 405 providers in 3 districts of Tanzania to determine the availability of PAC and providers' knowledge and preference for methods to treat incomplete abortion.

Only 14% of providers reported having received training on misoprostol for PAC. Forty percent of hospitals, 56% of health centers, and 15% of dispensaries had MVA kits in stock at time of survey. Almost two-thirds of providers reported they had not treated a case of incomplete abortion in the past year. The most common reasons stated were that these procedures are the responsibility of higher level providers (30%), that they were not trained to treat incomplete abortion (29%), facility policy is to refer these cases (23%), and that essential equipment is not always available (16%).

There needs to be targeted attention to increase the number of providers and facilities that provide PAC in Tanzania, including training providers on treatment of incomplete abortion and ensuring drugs and devices are available. PAC services should include treatment of incomplete abortion with misoprostol as a complement to MVA to ensure wider availability of services because it is an inexpensive, heat stable, and easy to administer tablet.