Online Program

Tackling two of the leading causes of maternal mortality in Zimbabwe by introducing misoprostol at all facility levels

Wednesday, November 6, 2013

Margaret Nyandoro, RN, MA, Zimbabwe Ministry of Health and Child Welfare, Harare, Zimbabwe
Tarra McNally, MA, MPH, Venture Strategies Innovations, Zimbabwe
Molly Moran, MPH, MA, Venture Strategies Innovations, Irvine, CA
Engeline Mawere, RN, Venture Strategies Innovations, Harare, Zimbabwe
Nuriye Nalan Sahin-Hodoglugil, MD, MPH, MA, Venture Strategies Innovations, Berkeley, CA
Melody Liu, B.A., Programs/Medical, Venture Strategies Innovations, Irvine, CA
Zimbabwe's maternal mortality ratio (MMR) of 960 is currently 50% higher than the average MMR in sub-Saharan Africa. The Zimbabwe Ministry of Health and Child Welfare (ZMoHCW) is committed to strengthening its health system by creating access to misoprostol, a uterotonic drug that can be used to manage postpartum hemorrhage (PPH) as well as to treat incomplete abortion and miscarriage. As PPH and unsafe abortion are two of the top five causes of maternal mortality in Zimbabwe, the ZMoHCW has formed a multi-pronged strategy for introducing misoprostol into the Zimbabwean health system. The strategy consists of: 1) policy change (e.g., introducing misoprostol on the Essential Drugs List of Zimbabwe as well as into the country's Postabortion Care Guidelines); 2) conducting operations research testing the feasibility of introducing misoprostol at all facility levels; and 3) working to revise the registration of a misoprostol product in the country to include obstetric indications. Despite the challenges of operating within an under-resourced health system, preliminary data from the operations research demonstrates that misoprostol is already being successfully used to manage PPH and treat incomplete abortion and miscarriage at all facility levels. The introduction of misoprostol to address two of the primary causes of maternal deaths has been identified by the ZMoHCW as a global best practice for scaling up facility-based maternal health services in low-income countries and a replicable model for strengthening health systems globally.

Learning Areas:

Administration, management, leadership
Program planning
Public health or related public policy

Learning Objectives:
Describe a multi-pronged strategy developed by the Zimbabwe Ministry of Health and Child Welfare for increasing the availability of misoprostol in all facility levels in Zimbabwe.

Keyword(s): Maternal Health, Access to Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Director of Reproductive Health at the Zimbabwe Ministry of Health and Child Welfare and I have led the strategic planning and implementation of numerous maternal health initiatives in Zimbabwe.
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.