دورية أكاديمية

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

التفاصيل البيبلوغرافية
العنوان: Landscape assessment of the availability of medical abortion medicines in India.
المؤلفون: Karna P; World Health Organization, Country Office for India, New Delhi, India., Sharma KA; Department of Obstetrics and Gynecology, All India Institute of Medical Science (AIIMS), New Delhi, India., Grossman A; Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA., Gupta M; World Health Organization, Country Office for India, New Delhi, India., Chatterjee T; World Health Organization, Country Office for India, New Delhi, India., Williams N; Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA., Prata N; Venture Strategies for Health & Development/OASIS, Berkeley, CA, USA.; Bixby Center for Population, Health & Sustainability, School of Public Health, University of California, Berkley, CA, USA., Sorhaindo A; UNDP‑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., Läser L; UNDP‑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., Rehnström Loi U; UNDP‑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., Ganatra B; UNDP‑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., Chaudhary P; World Health Organization, Country Office for India, New Delhi, India.
المصدر: Reproductive health [Reprod Health] 2024 Jun 05; Vol. 20 (Suppl 1), pp. 193. Date of Electronic Publication: 2024 Jun 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101224380 Publication Model: Electronic Cited Medium: Internet ISSN: 1742-4755 (Electronic) Linking ISSN: 17424755 NLM ISO Abbreviation: Reprod Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2004-
مواضيع طبية MeSH: Abortion, Induced*/statistics & numerical data , Abortion, Induced*/methods , Health Services Accessibility* , Abortifacient Agents*/supply & distribution , Misoprostol*/supply & distribution, Humans ; India ; Female ; Pregnancy ; Mifepristone/supply & distribution ; Drugs, Essential/supply & distribution
مستخلص: Background: Medical 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.
Methods: We 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.
Results: Medicines 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.
Conclusion: Opportunities 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.
(© 2024. The Author(s).)
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معلومات مُعتمدة: 001 International WHO_ World Health Organization
فهرسة مساهمة: Keywords: Abortion; Assessment; Availability; Combi-pack; India; Mifepristone; Misoprostol; Quality
Local Abstract: [plain-language-summary] Medical abortion is popular in India and benefits from a liberal legal context. It is important to understand the availability of quality abortion medicines in the country. Using the World Health Organization country assessment protocol and availability framework for medical abortion medicines we examined the availability of these medicines from supply to demand. We used this information to identify opportunities for increasing availability of quality-assured medical abortion medicines. We found that the context for medical abortion varies across states. Strengthening procurement and supply chain management, with a greater emphasis on quality-assurance and regulation of manufacturing should be instituted at the state-level. Training is also needed to increase provider knowledge of the latest national guidelines and laws to ensure respectful and person-centered services. Finally, the public should be informed about medical abortion as a safe and effective choice, especially for early abortions.
المشرفين على المادة: 0 (Abortifacient Agents)
0E43V0BB57 (Misoprostol)
320T6RNW1F (Mifepristone)
0 (Drugs, Essential)
تواريخ الأحداث: Date Created: 20240605 Date Completed: 20240606 Latest Revision: 20240720
رمز التحديث: 20240720
مُعرف محوري في PubMed: PMC11151496
DOI: 10.1186/s12978-024-01774-5
PMID: 38840263
قاعدة البيانات: MEDLINE
الوصف
تدمد:1742-4755
DOI:10.1186/s12978-024-01774-5