Source: Post-abortion drugs in short supply – DailyNews Live
Letwin Nyambayo 27 October 2018
HARARE – Health facilities that are meant to offer post-abortion care in
the country are experiencing shortages of essential drugs required to
provide for the service.
Research conducted by Tsungai Chipato of the University of Zimbabwe’s
Obstetrics and Gynaecology, in conjunction with Guttmacher Institute, the
ministry of Health and Child Care (MoHCC) and the Women’s Action Group
showed that 55 percent of the health facilities had run out of misoprotol
– an essential medicine for post-abortion care.
Thirty-five percent of the facilities had run out of blood for
transfusions, while another 35 percent had no intravenous antibiotics.
It was further observed that tertiary hospitals have the highest level of
stock outs of the drugs.
“The most affected institutions are the central hospitals. They have more
shortages than the smaller places yet they receive the most complicated
cases,” said Chipato when he presented the research findings.
It was also found that a fifth of public facilities asked women to pay for
post-abortion care prior to treatment even though these facilities are
supposed to provide the service at no cost to women.
“Due to the shortage of the drugs you find out that a patient comes with a
complicated case needing intravenous antibiotics and they have to buy the
drug at a private pharmacy.
“If they don’t have money, they die,” Chipato said.
He bemoaned the use of expensive procedures that carry greater risks of
further complications than medically recommended methods such as manual
vacuum aspiration and misoprostol.
Chipato said half of the hospital facilities designated under national
guidelines to provide manual vacuum aspiration did not have the equipment
to do so.
“A substantial proportion of first trimester post abortion cases are
treated using surgical procedures not recommended by the World Health
Organisation or national guidelines for this type of care,” he said,
adding that government should adequately fund central hospitals so that
they are never short of anything.
“Government has no excuse for not funding central hospitals when they keep
on flying people out for treatment. They should adequately stock essential
medicines and equipment for post-abortion care,” he said.
It was also recommended that nurses should also be trained and supported
to provide both misoprostol and manual vacuum aspiration.
According to the research, the MoHCC has made efforts to increase access
and improve post-abortion care in order to reduce maternal mortality but
the ongoing economic insecurity has limited the health systems’ capacity
to provide these services.
The ministry’s deputy director of Reproductive Health Margaret Nyandoro
confirmed that the post-abortion drugs supplies are very low.
While at least 40 percent of women who had an abortion in Zimbabwe
experience complications that required medical treatment, only half of
women with complications received the treatment they need.
Of the estimated 25 200 women receiving facility-based post abortion care
in 2016, about half were treated for complications related to unsafe
abortions.
Half of these cases were treated at district hospitals and one third at
larger central hospitals.
Among women treated for post-abortion complications, in 2016, 78 percent
had mild or moderate complications and 19 percent had severe complications
Three percent died or nearly died from complications.
Women experiencing complications from unsafe abortions in 2016, faced
delays in obtaining post-abortion care. On average, nearly two full days
elapsed between experiencing complications and receiving completed
treatment
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