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. 2017 Jul 3;17(1):211.
doi: 10.1186/s12884-017-1394-5.

Knowledge and provision of misoprostol among pharmacy workers in Senegal: a cross sectional study

Kate Reiss  1 , Katharine Footman  2 , Eva Burke  3 , Nafissatou Diop  4 , Ramatoulaye Ndao  3 , Babacar Mane  4 , Maaike van Min  1 , Thoai D Ngo  1
Affiliations

Knowledge and provision of misoprostol among pharmacy workers in Senegal: a cross sectional study

Kate Reiss et al. BMC Pregnancy Childbirth. .

Abstract

Background: Making misoprostol widely available for management of postpartum haemorrhage (PPH) and post abortion care (PAC) is essential for reducing maternal mortality. Private pharmacies (thereafter called "pharmacies") are integral in supplying medications to the general public in Senegal. In the case of misoprostol, pharmacies are also the main supplier to public providers and therefore have a key role in increasing its availability. This study seeks to understand knowledge and provision of misoprostol among pharmacy workers in Dakar, Senegal.

Methods: A cross-sectional survey was conducted in Dakar, Senegal. 110 pharmacy workers were interviewed face-to-face to collect information on their knowledge and practice relating to the provision of misoprostol.

Results: There are low levels of knowledge about misoprostol uses, registration status, treatment regimens and side effects among pharmacy workers, and corresponding low levels of training on its uses for reproductive health. Provision of misoprostol was low; of the 72% (n = 79) of pharmacy workers who had heard of the product, 35% (n = 27) reported selling it, though rarely for reproductive health indications. Almost half (49%, n = 25) of the respondents who did not sell misoprostol expressed willingness to do so. The main reasons pharmacy workers gave for not selling the product included stock outs (due to product unavailability from the supplier), perceived lack of demand and unwillingness to stock an abortifacient.

Conclusions: Knowledge and availability of misoprostol in pharmacies in Senegal is low, posing potential challenges for delivery of post-abortion care and obstetric care. Training is required to address low levels of knowledge of misoprostol registration and uses among pharmacy workers. Barriers that prevent pharmacy workers from stocking misoprostol, including weaknesses in the supply chain and stigmatisation of the product must be addressed. Low reported sales for reproductive health indications also suggest limited prescribing of the product by health providers. Further research is needed to explore the reasons for this barrier to misoprostol availability.

Keywords: Maternal mortality; Misoprostol; Pharmacy; Post abortion care; Postpartum haemorrhage; Reproductive health; Senegal.

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the Senegal National Ethics Committee for Health Research, the Institutional Review Board of the Population Council and Marie Stopes International Independent Ethics Review Committee. Pharmacy workers gave informed consent to participate in the study prior to the interviews being conducted. Endorsement for the study was obtained from the Order of Pharmacists who contacted all pharmacies in writing encouraging them to participate in the research. Neither pharmacies nor pharmacy workers received financial compensation for their participation.

Consent for publication

Not applicable.

Competing interests

KR, KF, EB, RN, MVM and TN worked for Marie Stopes Senegal or Marie Stopes International during study implementation. Marie Stopes Senegal and Marie Stopes International supported the registration of Misoclear in Senegal for PPH and PAC in 2011. ND and BM declare they that have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

References

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