Evidence map›Paper›PMID 38840263›Full record

ArticleReproductive health2024

Landscape assessment of the availability of medical abortion medicines in India.

Priya Karna, K Aparna Sharma, Amy Grossman, Madhur Gupta, Tapas Chatterjee, Natalie Williams, Ndola Prata, Annik Sorhaindo, Laurence Läser, Ulrika Rehnström Loi and 2 more

Abstract read
In one paragraph

Article in Reproductive health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Review
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

12 authors.

Priya KarnaWorld Health Organization, Country Office for India, New Delhi, India.
K Aparna SharmaDepartment of Obstetrics and Gynecology, All India Institute of Medical Science (AIIMS), New Delhi, India.
Amy GrossmanVenture Strategies for Health & Development/OASIS, Berkeley, CA, USA.
Madhur GuptaWorld Health Organization, Country Office for India, New Delhi, India.
Tapas ChatterjeeWorld Health Organization, Country Office for India, New Delhi, India.
Natalie WilliamsVenture Strategies for Health & Development/OASIS, Berkeley, CA, USA.
Ndola PrataVenture Strategies for Health & Development/OASIS, Berkeley, CA, USA.
Annik SorhaindoUNDP‑UNFPA‑UNICEF‑WHO‑World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
Laurence LäserUNDP‑UNFPA‑UNICEF‑WHO‑World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland. laserl@who.int.ORCID http://orcid.org/0009-0009-4841-0870
Ulrika Rehnström LoiUNDP‑UNFPA‑UNICEF‑WHO‑World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
Bela GanatraUNDP‑UNFPA‑UNICEF‑WHO‑World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland.
Pushpa ChaudharyWorld Health Organization, Country Office for India, New Delhi, India.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundMedical abortion with mifepristone and misoprostol can be provided up to 63 days' gestation in India. This accounts for 67.5 percent of all abortions in the country. We conducted an assessment to determine the availability of medical abortion medicines, specifically the combi-pack, in India.

methodsWe applied the World Health Organization landscape assessment protocol at the national level. The assessment protocol included a five-step adaptation of an existing availability framework, including online data collection, desk review, country-level key informant interviews, and an analysis to identify barriers and opportunities to improve medical abortion availability. The assessment was conducted between August and March 2021.

resultsMedicines for medical abortion are included in the national essential drug list and available with prescription in India. The assessment identified 42 combi-pack products developed by 35 manufacturers. The quality of medical abortion medicines is regulated by national authorities; but as health is devolved to states, there are significant inter-state variations. This is seen across financing, procurement, manufacturing, and monitoring mechanisms for quality assurance of medical abortion medicines prior to distribution. There is a need to strengthen supply chain systems, ensure consistent availability of trained providers and build community awareness on use of medical abortion medicines for early abortions, at the time of the assessment.

conclusionOpportunities to improve availability and quality of medical abortion medicines exist. For example, uniform implementation of regulatory standards, greater emphasis on quality-assurance during manufacturing, and standardizing of procurement and supply chain systems across states. Regular in-service training of providers on medical abortion is required. Finally, innovations in evidence dissemination and community engagement about the recently amended abortion law are needed.

Indexed as

Abortifacient AgentsAbortion, InducedHealth Services AccessibilityMisoprostolDrugs, EssentialFemaleHumansIndiaMifepristonePregnancyAbortifacient AgentsDrugs, EssentialMifepristoneMisoprostolAbortionAssessmentAvailabilityCombi-packIndiaMifepristoneMisoprostolQuality

Identifiers

PMID38840263
PMCPMC11151496

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Registered trials

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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.