265302 Expanding access to post-abortion care in Mozambique through the introduction of misoprostol

Tuesday, October 30, 2012 : 2:45 PM - 3:00 PM

Martine Holston, MPH , VSI: Venture Strategies Innovations, Berkeley, CA
Ndola Prata, MD, MSc , The Bixby Center for Population, Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA
Cassimo Bique, MD , Venture Strategies Innovations, VSI: Venture Strategies Innovations, Berkeley, CA
Natalie Williams, MPH , Venture Strategies Innovations, VSI: Venture Strategies Innovations, Berkeley, CA
Rachel Weinrib , VSI: Venture Strategies Innovations, Berkeley, CA
In Mozambique, abortion-related complications are a major cause of maternal mortality. Misoprostol is an effective, non-surgical alternative to manual vacuum aspiration (MVA) and has the potential to ensure PAC services are widely available. A study was conducted in two districts of Mozambique to demonstrate that misoprostol is feasible at all levels of the health system to treat incomplete abortion, with the goal of increasing access to PAC services. Misoprostol was introduced as a first line treatment of incomplete abortion for cases with a uterine size equivalent to gestational age up to 12 weeks without signs of complications. Data for analysis comes from client records, client exit interviews, and provider interviews. From July 2010-January 2011, 300 women were treated with misoprostol. Maternal and child health (MCH) nurses treated 86% of all cases. At the lowest level facilities, parteira elementars (low-level nurses not trained in MVA) treated 30% of women receiving misoprostol. Client records showed providers gave the correct dose and route of misoprostol in all cases. All providers participating in the provider interview (n=28) agreed or strongly agreed that it was easy to learn how to use misoprostol to treat incomplete abortion, that they felt comfortable using misoprostol to treat incomplete abortion, and that they would recommend misoprostol. This operations research demonstrated that quality PAC services can be provided at all levels of the Mozambican health care system. The introduction of misoprostol expanded access to PAC by building the capacity of providers not previously trained in MVA to treat incomplete abortion.

Learning Areas:
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Understand how misoprostol is an important component of comprehensive post-abortion care 2. Know how misoprostol can contribution to the expansion of post-abortion care services through increasing the number of providers and facilities that can provide these services

Keywords: Post-Abortion Care, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversaw the design, implementation, and evaluation of this program.
Any relevant financial relationships? No

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.