title: Community-level distribution of misoprostol to prevent postpartum hemorrhage at home births in northern Nigeria.
abstract: In Nigeria, most deaths due to postpartum hemorrhage (PPH) occur in the absence of skilled birth attendants. A study using community mobilization and the training of community drug keepers to increase access to misoprostol for PPH prevention was conducted in five communities around Zaria in Kaduna State, Nigeria. Community-oriented resource persons (CORPs) and traditional birth attendants (TBAs) recruited and counseled pregnant women on bleeding after delivery, the importance of delivery at a health facility, and the role of misoprostol. Drug keepers stored and dispensed misoprostol during a woman's third trimester of pregnancy. TBAs and CORPs enrolled 1,875 women from January through December 2009. These results are based on 1,577 completed postpartum interviews. Almost all women delivered at home (95%) and skilled attendance at delivery was low (7%). The availability of misoprostol protected 83% of women who delivered at home against PPH who otherwise would not have been protected. Policymakers working in similar contexts should consider utilizing commuity-level distribution models to reach women with this life-saving intervention.
authors.forename: Clara
authors.initials: C
authors.lastname: Ejembi
authors.forename: Oladapo
authors.initials: O
authors.lastname: Shittu
authors.forename: Molly
authors.initials: M
authors.lastname: Moran
authors.forename: Faraouk
authors.initials: F
authors.lastname: Adiri
authors.forename: Olugbenga
authors.initials: O
authors.lastname: Oguntunde
authors.forename: Babalafia
authors.initials: B
authors.lastname: Saadatu
authors.forename: Larai
authors.initials: L
authors.lastname: Aku-Akai
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Abdul
authors.forename: Victor
authors.initials: V
authors.lastname: Ajayi
authors.forename: Natalie
authors.initials: N
authors.lastname: Williams
authors.forename: Ndola
authors.initials: N
authors.lastname: Prata
mesh_terms: D003150:Community Health Workers; D005260:Female; D006801:Humans; D008880:Midwifery; D016595:Misoprostol / Q000008:administration & dosage* / Q000600:supply & distribution*; D009549:Nigeria; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D012424:Rural Population
chemical_list: D016595:Misoprostol