Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities.

Autor: Grossman A; Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA., Prata N; Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA.; Bixby Center for Population, Health & Sustainability, School of Public Health, University of California, Berkeley, CA, USA., Williams N; Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA., Ganatra B; UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland., Lavelanet A; UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland., Läser L; UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland., Asmani C; World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo., Elamin H; World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo., Ouedraogo L; World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo., Rahman MM; Directorate General of Family Planning, Karwarbazar, Dhaka, Bangladesh., Conneh-Duworko MJ; World Health Organization, Liberia Country Office, Monrovia, Republic of Liberia., Tehoungue BZ; Family Health Program, Ministry of Health, Monrovia, Republic of Liberia., Chanza H; World Health Organization, Malawi Country Office, Lilongwe, Republic of Malawi., Phiri H; Ministry of Health, Lilongwe, Republic of Malawi., Bhattarai B; Department of Drug Administration, Ministry of Health and Population, Kathmandu, Nepal., Dhakal NP; Ministry of Health and Population, Kathmandu, Nepal., Ojo OA; World Health Organization, Nigeria Country Office, Abuja, Federal Republic of Nigeria., Afolabi K; Reproductive Health, Federal Ministry of Health, Abuja, Federal Republic of Nigeria., Kabuteni TJ; World Health Organization, Rwanda Country Office, Kigali, Republic of Rwanda., Hailu BG; World Health Organization, Sierra Leone Country Office, Freetown, Sierra Leone., Moses F; Reproductive Health/Family Planning Programme Manager, Ministry of Health, Freetown, Sierra Leone., Dlamini-Nqeketo S; World Health Organization, South Africa Country Office, Pretoria, Republic of South Africa., Zulu T; National Department of Health, Pretoria, Republic of South Africa., Rehnström Loi U; UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland. rehnstromu@who.int.
Jazyk: angličtina
Zdroj: Reproductive health [Reprod Health] 2023 Apr 11; Vol. 20 (Suppl 1), pp. 58. Date of Electronic Publication: 2023 Apr 11.
DOI: 10.1186/s12978-023-01574-3
Abstrakt: Background: In recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider's knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels.
Methods: Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020.
Results: Registration of abortion medicines-misoprostol or a combination of mifepristone and misoprostol-was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone-countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula-no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option.
Conclusion: Understanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access.
(© 2023. World Health Organization.)
Databáze: MEDLINE
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