Roundtable: Making Pregnancy Safer in Myanmar: Introducing Misoprostol to Prevent Post-Partum Haemorrhage as Part of Active Management of the Third Stage of Labour

Abstract

In Myanmar we carried out a successful pilot intervention with the prostaglandin misoprostol in the active management of the third stage of labour for prevention of post-partum haemorrhage. The pilot aimed to appraise the operational feasibility efficiency impact and cost-effectiveness of the intervention at family and community level and focused on a number of managerial and logistics issues in relation to scaling-up the intervention nationally and within the public sector where it proved to be successful. Myanmar is the largest country in mainland Southeast Asia geographically with over 70% of its population in rural areas. Over 60% of the population (55.4 million in December 2006) consists of mothers and children who are the most vulnerable group. Administratively there are 14 states and divisions which are sub-divided into 66 districts 325 townships and so on down to 65148 villages. Maternity care is equally spread across the whole country in both urban and rural areas but thereis still an under-served group in very remote hard-to-reach areas though their numbers are not very large. The number of facilities with functioning basic essential obstetric care in 2005 was eight per 500000 population and that of comprehensive essential obstetric care was four per 500000 population. (excerpt)