Abstract:
In July 2012, in Dar es Salaam, Tanzania, more
than 35 obstetrician/gynecologists, nursemidwives
and public health professionals working
in Africa recommitted to and reinvigorated their
efforts towards achieving Millennium
Development Goal (MDG) 5 at a Regional
Experts’ Summit. During the weeklong conference
convened to explore the myriad factors
contributing to maternal mortality in the 12
African countries represented, the experts
identified solutions that exist today, and that can
be made available on a large scale to confront
preventable maternal deaths. One such solution,
misoprostol, is a simple and effective medicine
that can contribute significantly to our efforts to
reduce maternal mortality.
Given its status as a safe and effective medicine
that is both heat-stable and easy to administer, the
potential of misoprostol to save women’s lives is
largely untapped. Misoprostol is recognized by the
World Health Organization (WHO) as an essential
medicine for addressing two major causes of
maternal mortality: postpartum hemorrhage (PPH)
and unsafe abortion1, 2. FIGO, the International
Federation of Gynecology and Obstetrics, also
recommends misoprostol for all of its obstetric and
gynecologic indications, including prevention and
treatment of PPH, treatment of incomplete
abortion, treatment of missed abortion, medical
abortion, cervical ripening and induction of labor3.
WHO’s 2012 guidelines recommend the provision
of misoprostol for prevention of PPH by
community health care workers and lay health
workers where skilled health workers and oxytocin
are not available4. This is in addition to its
inclusion in the WHO’s Safe Abortion Technical
and Policy
Guidance for Health Systems in combination with
mifepristone or alone for termination of
pregnancy5.
Backed by these policy endorsements and peerreviewed
literature, and drawing upon a breadth of
experiences of introducing misoprostol for
maternal health throughout Africa, the experts
identified three primary activities that must be
accelerated now to save more women’s lives in
our communities, and our countries.
