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Int J Gynaecol Obstet. 2014 Feb;124(2):164-8. doi: 10.1016/j.ijgo.2013.07.037. Epub 2013 Oct 31.

Availability and provision of misoprostol and other medicines for menstrual regulation among pharmacies in Bangladesh via mystery client survey.

Author information

1
Centre for Reproductive Health, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh. Electronic address: fauzia@icddrb.org.
2
Research, Monitoring and Evaluation Team, Health System Department, Marie Stopes International, London, UK.
3
Centre for Reproductive Health, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

Abstract

OBJECTIVE:

To explore the availability and provision of misoprostol and other medicines for menstrual regulation (MR) among pharmacies in Bangladesh.

METHODS:

Between March and November 2011, a cross-sectional study using mystery client visits was conducted among pharmacy workers in Dhaka and Gazipur Districts, Bangladesh. Mystery clients were trained to present 1 of 4 pre-developed situations to pharmacy workers to elicit information on the regimen, adverse effects, and complications of misoprostol use.

RESULTS:

Mystery clients visited 331 pharmacies. Among the 331 pharmacy workers, 45.8% offered the mystery clients misoprostol and/or other medicines for MR; 25.7% referred them to private clinics or hospitals. Only 7% recommended an effective regimen of misoprostol for MR; 65% suggested administering vaginal and oral misoprostol together. Overall, 72.4% did not provide any advice on complications; the remainder suggested visiting trained providers for complications. Counseling on excessive bleeding as a danger sign was provided by 46% of pharmacy workers. Most (94%) did not provide or refer for post-MR family planning.

CONCLUSION:

Pharmacy workers in urban Bangladesh are providing ineffective drugs and regimens for MR. A training package is needed to strengthen service delivery by providing accurate information, high-quality products, and referral mechanisms for women seeking MR through pharmacies.

KEYWORDS:

Abortion; Bangladesh; Menstrual regulation; Misoprostol; Pharmacy workers

PMID:
24268354
DOI:
10.1016/j.ijgo.2013.07.037
[Indexed for MEDLINE]
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