Panafrican News Agency

Low quality supplies of Oxytocin, misoprostol hamper efforts to improve maternal health in Sub-Saharan Africa

Kigali, Rwanda (PANA) - The lack of access to safe maternal health services during the critical hours of childbirth remains a key barrier to national efforts to save the lives of mothers and their children in Sub-Saharan Africa, said Dinev Milka, one of the senior advisors for the global Reproductive Health Supplies Coalition (RHSC) in an exclusive interview with PANA on Tuesday.

"The other barriers that pregnant women face in Africa and in most low- and middle-income countries is that essential maternal supplies such as oxytocin, magnesium sulfate, misoprostol and antihypertensives could be of low quality without enough active ingredient which render them ineffective," Milka told PANA.

Milka, who has vast experience in providing technical assistance to several programs focusing on sexual and reproductive health, family planning, mainly in three African countries (Angola, Egypt and Nigeria), also noted that although governments have made tremendous efforts to improve the supply chains, especially for medicines, there are still structural difficulties such as roads and transportation.

Experts argue that Oxytocin, misoprostol and magnesium sulfate are the main drugs used for preventing and treating the two leading causes of maternal mortality, but the lack of adequate storage methods of these supplies still puts the existing healthcare system at a disadvantage .

"Our governments have made tremendous efforts to improve the supply chains especially for medicines, but there are still structural difficulties such as roads and transportation, access to qualified human resources, and enough resources to fund the supply chain," Milka said.

According to the estimates by the World Health Organization (WHO), the most effective medicines used to prevent postpartum hemorrhage (PPH) - the leading cause of maternal death in Sub-Saharan Africa - are mainly oxytocin and misoprostol.

Although Oxytocin is effective more than other uterotonic medicines, the drug is temperature sensitive and relatively expensive when compared to Misoprostol, the UN agency said.

In a move to ensure that quality life-saving medicines are available for every woman, for every birth and where-ever that takes place, Milka stressed that African governments, manufacturers, multi and bilateral organizations, international and local NGOs, and specialists must have the mission of reaching every woman and adolescent with the correct supplies at the appropriate time.

Across several countries in Sub-Saharan African countries, reports indicate that all public health facilities obtain essential and vital pharmaceuticals primarily through the integrated pharmaceuticals logistics system (IPLS), a single reporting and distribution system based on the overall mandate and scope of the national Pharmaceuticals Fund and Supply Agency.

It is said that one of the challenges mainly observed is related to the availability and use of life saving maternal health medicines and equipment at remote health facilities in Sub-Saharan Africa.

"The gap is likely to widen again in providing the medicines at very low cost, and countries in Sub-Saharan Africa should determine their readiness towards integrating the provision of quality supplies in their health extension programs," Milka said.

The Reproductive Health Supplies Coalition recommends that African governments should ensure that Ministries of Finance increase and efficiently execute budgets for health product regulation and enforce adherence to quality regulations by all suppliers.

It also recommends that global recommendations on storage and distribution of maternal health products are widely disseminated and reflected in national strategies, guidelines, and operational practices.

This is because the major problem is that those supplies could degrade due to heat (in the case of oxytocin) and due to humidity (in the case of misoprostol), the expert said.
-0- PANA TWA/VAO 17April2018