ArticleBMJ open2025
Access to oxytocin, misoprostol, heat-stable carbetocin and tranexamic acid for management of postpartum haemorrhage in the Democratic Republic of the Congo, India and Kenya: a cross-sectional survey of drug availability and pricing.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Moving beyond a legacy paradigm: A vision for equitable access to quality medicines in Africa.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim was to assess point-in-time stock availability and pricing of drugs used for postpartum haemorrhage management (oxytocin, misoprostol, heat-stable carbetocin and tranexamic acid (TXA)).
designCross-sectional point-in-time survey using an adapted version of the WHO/Health Action International methodology.
settingIn public, for-profit and not-for-profit private health facilities and in pharmacies in the Democratic Republic of the Congo (DRC), India and Kenya.
participants211 health facilities in the DRC (n=63), India (n=76) and Kenya (n=72). PRIMARY AND SECONDARY OUTCOME MEASURES: Availability was calculated as a mean percentage of facility types where each medicine was observed on the day of data collection. Average procurement prices were calculated by obtaining the current purchase price per drug at each facility and then averaging prices across all facility types.
resultsAvailability of the four medicines was limited, and only oxytocin in the DRC met the WHO's benchmark of 80%. Across all countries, availability of oxytocin, misoprostol and TXA was lower in public health facilities than in other facility types, indicating an important gap. Where the four medicines were available, non-quality-assured products were predominant across the three countries. The average facility procurement prices in India and Kenya were reported to be lower than those in the DRC.
conclusionsAvailability of oxytocin, misoprostol, heat-stable carbetocin and TXA was suboptimal and varied by facility type and geography, and similar trends were found across the four drugs. This indicates that access strategies should be tailored to each drug, geographical area and facility type. Strategies to improve commodity access in public-sector facilities will be especially important, as well as improving the availability of quality-assured products, possibly through value-based procurement practices.
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