OROMIA REGION, ETHIOPIA

In preparation for the government’s expected regulatory approval of misoprostol for the control of postpartum hemorrhage (PPH), Venture Strategies, under the supervision and guidance of Drs. Tesfanesh Balay and Tekle-Ab Mekbib, at the Family Health Department of the Ethiopian Ministry of Health and with our collaborating agency DKT-Ethiopia, has initiated trainings for the prevention of PPH by introducing misoprostol at the community level. 

In December 2006, the Family Health Department, having recognized PPH as the major cause of maternal mortality in the country, initiated the project titled, “Misoprostol for the prevention of PPH at the community level.”  A key project strategy targets training for the lowest level health care professionals in Ethiopia, the health extension worker (HEW), in an effort to meet the needs of the predominantly rural populations of Ethiopia.

As of May 2007, 128 HEWs representing 97 rural health posts throughout four regions of the country - Amhara, Tigray, Southern (SNPPR) and Oromia - have been trained in the administration of oral misoprostol tablets to women during the third stage of labor to prevent PPH. These trainings come on the heels of the Ministry of Health's recent inclusion of misoprostol in the national drug list as an excellent and safe drug for the prevention and treatment of PPH and a federal initiative to strengthen community-based health programs targeting the rural and under-served populations of Ethiopia.

Objectives of the project are to raise awareness among community members and health care providers regarding the availability of a simple technology for the prevention of PPH and to determine the safety, acceptability and effectiveness of orally administered misoprostol for community level management of PPH.  The administration of misoprostol by HEWs to the women in greatest need, rural mothers in labor, is considered to be as a life saving act by the Ministry of Health, and an innovative strategy to reduce the high maternal mortality secondary to PPH at the community level. This project is the first of its kind in the country, and it is expected to have far reaching implications in safe motherhood efforts.