In Tanzania, we are working diligently to improve women’s access to misoprostol for a healthier pregnancy and childbirth. As reported last time, we are in the midst of an in-depth series of assessments that are evaluating access to the essential medicine, misoprostol. Our latest results focus on the women themselves. We traveled to three districts (Kilombero, Ulanga and Morogoro Rural) to conduct a survey with over 1,300 women and mothers to get a sense of their knowledge, attitudes and practices related to the prevention of excessive bleeding after childbirth, or postpartum hemorrhage (PPH), and misoprostol to prevent this life-threatening bleeding. We were also keen to assess the role of community awareness activities in increasing their awareness about PPH and misoprostol.
The women we spoke with had varied experiences: some were first-time mothers, others a mother to multiple children, and a few had no children at all. It was important to understand the perceptions of all women on the dangers of childbirth. While some mothers had delivered at home, most had delivered their babies in a facility, signaling that mothers are getting the message that the facility is the safest place to give birth. Nearly half of the mothers surveyed had given birth in the past three years, since the VSI PPH prevention program had been initiated in two of the districts. Overall, a quarter of all women interviewed had heard of misoprostol; this figure increased in previous VSI program districts to nearly half of women having heard of misoprostol through one of our community awareness campaigns. For instance, one in five women reported seeing one of our program posters. Perhaps most encouragingly, women remembered information they had received nearly three years earlier on how to prepare for a safer childbirth and misoprostol. Mothers listen to other mothers, so this result is important.
An interesting result that can help shape future programming is that we asked women their opinions on the best ways to share information with the community about bleeding at birth and misoprostol. Women from Ulanga mentioned dramas and community meetings (30%), while women in Kilombero and Morogoro Rural mentioned posters and radio as the best means to share information. But most frequently, women across the districts mentioned that community health workers would be the best way to share information about these topics. VSI has always recognized the important role these volunteers and traditional birth attendants can play as trusted members of the community, and we will continue to do so.
As a supporter of our program in Tanzania you played a part to spread the word at the village level about the role misoprostol can have to save women’s lives in childbirth. And the women are listening! But, there is still much to do and to understand about our past efforts to ensure women can access misoprostol when and where they need it most. The reason is clear: One woman lost is one too many—especially when we have the tools, medicines and knowledge to prevent it. We invite you to follow our progress during this important assessment phase. Together we can make a difference and save women’s lives.