title: Increasing Access to Prevention of Postpartum Hemorrhage Interventions for Births in Health Facilities and at Home in Four Districts of Rwanda.
abstract: To assess coverage, acceptability, and feasibility of a program to prevent postpartum hemorrhage (PPH) at community and facility levels, a study was conducted in 60 health facilities and their catchment areas in four districts in Rwanda. A total of 220 skilled birth attendants at these facilities were trained to provide active management of the third stage of labor and 1994 community health workers (ASMs) were trained to distribute misoprostol at home births. A total of 4,074 pregnant women were enrolled in the program (20.5% of estimated deliveries). Overall uterotonic coverage was 82.5%: 85% of women who delivered at a facility received a uterotonic to prevent PPH; 76% of women reached at home at the time of birth by an ASM ingested misoprostol--a 44.3% coverage rate. Administration of misoprostol at the time of birth for home births achieved moderate uterotonic coverage. Advancing the distribution of misoprostol through antenatal care services could further increase coverage.
authors.forename: Blami
authors.initials: B
authors.lastname: Dao
authors.forename: Fidele
authors.initials: F
authors.lastname: Ngabo
authors.forename: Jeremie
authors.initials: J
authors.lastname: Zoungrana
authors.forename: Barbara
authors.initials: B
authors.lastname: Rawlins
authors.forename: Beata
authors.initials: B
authors.lastname: Mukarugwiro
authors.forename: Pascal
authors.initials: P
authors.lastname: Musoni
authors.forename: Rachel
authors.initials: R
authors.lastname: Favero
authors.forename: Juliet
authors.initials: J
authors.lastname: MacDowell
authors.forename: Kanyamanza
authors.initials: K
authors.lastname: Eugene
mesh_terms: D000328:Adult; D003150:Community Health Workers / Q000458:organization & administration / Q000592:standards; D005260:Female; D006700:Home Childbirth / Q000379:methods* / Q000592:standards; D006771:Hospitals, Maternity / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data; D016595:Misoprostol / Q000627:therapeutic use; D036801:Parturition; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D011247:Pregnancy; D012432:Rwanda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D016595:Misoprostol