141st APHA Annual Meeting

In This section

Pharmacy employee knowledge and attitudes related to misoprostol and abortion in Tanzania

Monday, November 4, 2013 : 2:45 PM - 3:00 PM

Alice Cartwright, MPH , VSI: Venture Strategies Innovations - Tanzania, Dar es Salaam, Tanzania
Melissa Higbie, MBA, MPH , VSI: Venture Strategies Innovations - Tanzania, Dar es Salaam, Tanzania
Selemani Mbuyita, MPH , Ifakara Health Institute, Dar es Salaam, Tanzania
Olivia Reyes, MPH , VSI: Venture Strategies Innovations, Irvine, CA
Melody Liu , VSI: Venture Strategies Innovations, Irvine, CA
Ndola Prata, MD, MSc , The Bixby Center for Population, Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA
Misoprostol is a drug widely used in the provision of medication abortion. While misoprostol is sold in many developing countries, legal restrictions on abortion, particularly in sub-Saharan Africa, limit its registration for this indication. Studies in Latin America have explored pharmacy sales of misoprostol for abortion, but there is limited data from African countries. We surveyed 179 pharmacy employees from 150 pharmacies in seven regions of Tanzania in April 2012 to determine stock availability and knowledge and attitudes regarding misoprostol sales. One-third (32%) of pharmacies had misoprostol in stock at the time of the survey. The most common reason mentioned for ordering misoprostol was demand from individual customers, while those pharmacies who did not order reported that they feared the drug would be “misused”. One-third of respondents (32%) spontaneously mentioned abortion as an indication for which misoprostol could be used; however, less than 10% could give an appropriate dose. Half of respondents reported ever dispensing misoprostol, with 19% of those citing abortion was the most common reason for which women purchase the drug. In addition, reported prescription requirement was high. In legally restrictive settings, misoprostol sold by pharmacies is likely used for medication abortion. However, correct dose information is limited, increasing the probability of women experiencing incomplete abortions. Future research should include simulated sales encounters, including mystery shoppers, to validate the extent to which and for what indications pharmacies in countries with legal restrictions on abortion sell misoprostol to consumers.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Discuss the legally restrictive status of abortion in Tanzania and attitudes of pharmacy employees regarding misoprostol ordering and sales. Identify opportunities for improving knowledge of dosage and changing attitudes of pharmacy employees for misoprostol for all obstetric indications.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have led the organizational research activities for a national assessment of misoprostol availability in Tanzania. In addition, I have been part of a team for over 3 years that has implemented operations research projects on community-based distribution of misoprostol for PPH prevention and expansion of postabortion care services to include misoprostol.
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.