Table 5 Recommendations by the expert panel from the UUIFB estimation exercise in each setting
Setting | Key recommendations |
|---|---|
Jharkhand, India | ● Promote awareness among women and families about the potential and correct use of misoprostol for prevention of PPH. |
● Develop a program for the advanced distribution of misoprostol to women who deliver at home. | |
● Improve commodity management to reduce the rate of stock-outs of uterotonic drugs. | |
● Further understand and improve the quality of oxytocin. | |
● Improve data gathering and data quality for UUIFB. | |
Mozambique | ● Improve UUIFB coverage in the public sector through quality improvement measures. |
● Expand the use of misoprostol in the community. Just expanding to the 35 planned districts this year would increase national UUIFB coverage by more than 10%. | |
● Emphasize in maternity norms that oxytocin should be given within one minute of birth. The birth attendant must prepare the dose before the birth. | |
● The MOH should authorize all providers who attend births to give oxytocin. | |
● Given its importance as a medicine, the need is urgent to investigate the potency of oxytocin. | |
● MCHIP could make funds available to finance the purchase of equipment to strengthen the cold chain for oxytocin. | |
Tanzania | ● Improve data on home-based use of uterotonics. |
● Improve commodity management and tracking, especially at lower level health facilities | |
● Track stockout of all possible approved uterotonics, rather than tracking them individually | |
● Improve data quality and gathering on UUIFB, including defining UUIFB for these purposes | |
Yemen | ● Increase supply of uterotonics in facilities |
● Increase knowledge of providers about uterotonic use | |
● Develop educational materials to clarify providers’ understanding of the benefits and uses of misoprostol | |
● Pilot the use of misoprostol for prevention of PPH at home birth | |
● Review/modify the job description of midwives to ensure permission to use misoprostol for PPH prevention | |
● Work with High Commission for Medications to approve the use of misoprostol for PPH prevention and treatment. |