Reiss, Kate; Keenan, Katherine; Church, Kathryn; Dijkerman, Sally; Mitu, Shahida Akter; Nuremowla, Sadid; Ngo, Thoai D; (2019) Drug Seller Provision Practices and Knowledge of Misoprostol in Bangladesh. International Perspectives on Sexual and Reproductive Health, 45. pp. 45-54. ISSN 1944-0391 DOI: https://doi.org/10.1363/45e7819
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Abstract
CONTEXT: In Bangladesh, prior to the availability of the approved combination regimen of mifepristone and misoprostol for menstrual regulation (MR), drug seller provision of misoprostol-only regimens for MR without a prescription was widespread but service quality was poor. Examining provider practices relating to misoprostol-only provision in Bangladesh may increase understanding of misoprostol use and provision in other low-resource, legally restrictive settings. METHODS: In 2013-2014, a countrywide cross-sectional knowledge, attitudes and practice survey was conducted among 777 randomly selected drug sellers; data were analyzed descriptively. Logistic regression was used to test the associations between exposure to three interventions designed to improve drug seller practice (nongovernmental organization [NGO]-led training, a call center and in-shop training from pharmaceutical company representatives) and correct knowledge of the misoprostol-only MR regimen. RESULTS: Almost all (97%) of the drug sellers reported providing medications intended for MR; misoprostol-only was more commonly sold than the combination regimen (96% vs. 26%). Nine percent had received NGO-led training, 62% had received in-shop training from a pharmaceutical company representative and 27% had used the call center. Overall, 19% of drug sellers knew the correct misoprostol-only MR regimen, and 74% wanted more information about this regimen. Correct regimen knowledge was positively associated with receipt of NGO training and call center utilization (odds ratios, 2.0 and 1.9, respectively). CONCLUSIONS: NGO-led training and call centers should be considered in other settings in which misoprostol alone is provided off-label for pregnancy termination.
Item Type | Article |
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Faculty and Department |
Faculty of Epidemiology and Population Health Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) |
Research Centre | Population Studies Group |
PubMed ID | 31639080 |
Elements ID | 139865 |
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