Nigeria takes groundbreaking step with approval of guidelines for community use of misoprostol

31.01.2011 (ABUJA, NIGERIA) – In December 2010, Nigeria became the first country in the world to endorse guidelines for the use of misoprostol tablets for prevention of postpartum hemorrhage (PPH) at the community level. Nigeria exhibited similar global leadership in 2006 when it was the first country to register the tablets for use in prevention and treatment of PPH to address its high rate of maternal mortality. Nigeria contributes to approximately 10% of the world’s maternal deaths, and excessive bleeding after delivery, or PPH, is the leading cause. With a majority of women delivering their babies at home, the approval of use of misoprostol tablets at the community level offers the most vulnerable women access to a life-saving solution.

Venture Strategies Innovations (VSI) and the Population and Reproductive Health Partnership (PRHP), a research unit within Ahmadu Bello University in Kaduna State, principally Dr. Clara Ejembi of PRHP, drafted the guidelines for Community Use of Misoprostol for Prevention and Treatment of Postpartum Hemorrhage in Nigeria, after demonstrating that distribution of misoprostol tablets directly to expectant mothers and community-level agents is a safe and effective way to increase protection against PPH. A technical review team comprised of representatives from the Federal Ministry of Health and local and international nongovernmental organizations finalized and approved the guidelines at a technical working group meeting December 13-15, 2010 in Abuja, Nigeria. They will ready for printing and distribution in early 2011.

One year ago in February 2010, the implementing partners, VSI, PRHP and the Bixby Center for Population, Health and Sustainability at the University of California, Berkeley, shared the results of this research project with over 400 supportive members of the five participating communities and government representatives. Building on this momentum and evidence, the National Council on Health put forth a recommendation for community-level use of misoprostol for PPH in March 2010. The recommendation was met by a request from the Federal Ministry of Health, Department of Family Health, to revise the existing facility-based guidelines and allow for use of the tablets by community-level agents and self-administration by mothers. The recently approved guidelines are the culmination of these efforts.

The implementation of these guidelines in accordance with the Nigerian Federal Ministry of Health’s community-based service delivery strategy will enable distribution of misoprostol tablets in communities with the greatest need for a feasible solution to this leading cause of maternal death.

For more on VSI’s work in Nigeria, click here.