title: Feasibility, acceptability, and programme effectiveness of misoprostol for prevention of postpartum haemorrhage in rural bangladesh: a quasiexperimental study.
abstract: We explored the feasibility of distributing misoprostol tablets using two strategies in prevention of postpartum haemorrhage (PPH) among women residing in the Abhoynagar subdistrict of Bangladesh. We conducted a quasiexperimental study with a posttest design and nonequivalent comparison and intervention groups. Paramedics distributed three misoprostol tablets, one delivery mat (Quaiyum's delivery mat), a packet of five standardized sanitary pads, and one lidded plastic container with detailed counseling on their use. All materials except misoprostol were also provided with counseling sessions to the control group participants. Postpartum blood loss was measured by paramedics using standardized method. This study has demonstrated community acceptability to misoprostol tablets for the prevention of PPH that reduced overall volume of blood loss after childbirth. Likewise, the delivery mat and pad were found to be useful to mothers as tools for assessing the amount of blood loss after delivery and informing care-seeking decisions. Further studies should be undertaken to explore whether government outreach health workers can be trained to effectively distribute misoprostol tablets among rural women of Bangladesh. Such a study should explore and identify the programmatic requirements to integrate this within the existing reproductive health program of the Government of Bangladesh.
authors.affiliation: Centre for Reproductive Health, icddr,b, Bangladesh.
authors.forename: Abdul
authors.initials: A
authors.lastname: Quaiyum
authors.affiliation: Centre for Equity and Health Systems, icddr,b, Mohakhali C/A, Dhaka 1212, Bangladesh.
authors.forename: Rukhsana
authors.initials: R
authors.lastname: Gazi
authors.affiliation: Centre for Equity and Health Systems, icddr,b, Mohakhali C/A, Dhaka 1212, Bangladesh.
authors.forename: Shahed
authors.initials: S
authors.lastname: Hossain
authors.affiliation: Department of Epidemiology, The Centre for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street/E7144, Baltimore, MD 21205, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wirtz
authors.affiliation: Health Systems and Infectious Diseases Division, icddr,b, Bangladesh.
authors.forename: Nirod Chandra
authors.initials: NC
authors.lastname: Saha