Gynuity Study Leads to Scaled-up PPH Prevention Strategy in Senegal

Following a research study conducted by Gynuity Health Projects and ChildFund Senegal that examined the use of misoprostol (600 mcg oral) or oxytocin (10 UI) via Uniject® at the community level for prevention of postpartum hemorrhage (PPH), Senegal’s Minister of Health and Social Action convened a meeting of the Health Commission in March, 2014, to discuss possible national scale-up of the PPH prevention protocol. Only a select few community pilot interventions with potential high impact are selected for discussion at the Commission. Based on study results of both uterotonics, the committee determined that misoprostol should be the drug of choice at the community level. This decision was based on its ease of use, simplicity of storage, and affordability, in addition to the fact that misoprostol is currently available, registered in-country, and is on Senegal’s essential medicines list, while Uniject® is not currently available.

A second impact of this research is the potential for task shifting among health delivery workers. In Senegal, matrones (birth attendants) work in health huts at the lowest level of the health care system. Matrones are only authorized to assist women in cases of imminent birth, and otherwise women in labor are to be referred to higher levels of care. This study demonstrates that matrones can successfully administer either misoprostol or oxytocin in Uniject® for PPH prevention, suggesting that they could play a more legitimized role in non-imminent deliveries if policy changes supported such a shift.