Evidence map›Paper›PMID 32268892›Full record

ArticleBMC international health and human rights2020

Misoprostol for the prevention of post-partum haemorrhage in Mozambique: an analysis of the interface between human rights, maternal health and development.

Karen Hobday, Anthony B Zwi, Caroline Homer, Renae Kirkham, Jennifer Hulme, Páscoa Zualo Wate, Ndola Prata

Open access · goldAbstract read
In one paragraph

Article in BMC international health and human rights, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 7 institutions in 4 countries.

Karen HobdayMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, NT, 0811, Australia. Karen.hobday@menzies.edu.au.
Anthony B ZwiHealth, Rights and Development (HEARD@UNSW), Faculty of Arts and Social Sciences, University of New South Wales, Sydney, NSW, 2052, Australia.
Caroline HomerBurnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
Renae KirkhamMenzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, NT, 0811, Australia.
Jennifer HulmeDepartment of Family and Community Medicine, University of Toronto, Toronto, Canada.
Páscoa Zualo WateDepartment of Women's and Child Health, Ministry of Health, Avenida Eduardo Mondlane, Maputo, Mozambique.
Ndola PrataBixby Center for Population, Health and Sustainability, University of California-Berkeley, University Hall, Berkeley, CA, 94720-6390, USA.
Burnet Institute · AUCharles Darwin University · AUMenzies School of Health Research · AUMinistry of Health · MZUniversity of California, Berkeley · USUniversity of Toronto · CAUNSW Sydney · AU

Funding

Australian Research Training Scholarship N/A
6 · The paper itself

Abstract

backgroundMozambique has high maternal mortality which is compounded by limited human resources for health, weak access to health services, and poor development indicators. In 2011, the Mozambique Ministry of Health (MoH) approved the distribution of misoprostol for the prevention of post-partum haemorrhage (PPH) at home births where oxytocin is not available. Misoprostol can be administered by a traditional birth attendant or self-administered. The objective of this paper is to examine, through applying a human rights lens, the broader contextual, policy and institutional issues that have influenced and impacted the early implementation of misoprostol for the prevention of PPH. We explore the utility of rights-based framework to inform this particular program, with implications for sexual and reproductive health programs more broadly.

methodsA human rights, health and development framework was used to analyse the early expansion phase of the scale-up of Mozambique's misoprostol program in two provinces. A policy document review was undertaken to contextualize the human rights, health and development setting in Mozambique. Qualitative primary data from a program evaluation of misoprostol for the prevention of PPH was then analysed using a human rights lens; these results are presented alongside three examples where rights are constrained.

resultsStructural and institutional challenges exacerbated gaps in the misoprostol program, and sexual and reproductive health more generally. While enshrined in the constitution and within health policy documents, human rights were not fully met and many individuals in the study were unaware of their rights. Lack of information about the purpose of misoprostol and how to access the medication contributed to power imbalances between the state, health care workers and beneficiaries. The accessibility of misoprostol was further limited due to dynamics of power and control.

conclusionsApplying a rights-based approach to the Mozambican misoprostol program is helpful in contextualising and informing the practical changes needed to improve access to misoprostol as an essential medicine, and in turn, preventing PPH. This study adds to the evidence of the interconnection between human rights, health and development and the importance of integrating the concepts to ensure women's rights are prioritized within health service delivery.

Indexed as

Health Services AccessibilityHuman RightsMaternal HealthPostpartum HemorrhageProgram EvaluationAdultFemaleHome ChildbirthHumansInterviews as TopicMaternal MortalityMisoprostolMozambiquePregnancyMisoprostolDevelopmentHuman rightsMaternal healthMozambiquePost-partum haemorrhageRight to health

Identifiers

PMID32268892
PMCPMC7140325
OpenAlexW3015772454

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.