Bangladeshi women failing to receive basic lifesaving drugs in pregnancy and childbirth

News Hour:

Global health organization PATH and local NGO SERAC-Bangladesh today joined together to highlight the fact that many Bangladeshi women lack access to the life-saving medicines that can prevent the two leading causes of death during pregnancy and childbirth – postpartum hemorrhage and pre-eclampsia/eclampsia.

A new paper by PATH, “Stronger markets, increased access to maternal health supplies,” details how inconsistent availability and poor-quality supplies of oxytocin, misoprostol, and magnesium sulfate in the country threaten women’s lives, and what can be done to solve the problem.

Bangladesh has the tenth-highest burden of maternal mortality globally, and in 2015 about half of all maternal deaths were caused by uncontrolled bleeding after childbirth, also known as postpartum hemorrhage, and a condition that causes high blood pressure and seizures during pregnancy called pre-eclampsia/eclampsia. Medicine to prevent and treat these conditions – oxytocin and misoprostol for postpartum hemorrhage and magnesium sulfate for pre-eclampsia/eclampsia – are affordable, effective, and promoted for use by the global health community.

However in Bangladesh, inconsistent availability and supply of products of poor or unverified quality put pregnant women at risk. For example, a study found that, as of March 2016, none of these drugs registered in Bangladesh had been verified to meet international standards for quality. Another study examining drug storage in three districts discovered that even though oxytocin requires refrigeration, a significant proportion of public and private drug shops stored the drug on shelves, threatening product safety and efficacy.

“Access to quality medicine could save thousands of mothers’ lives every year, but currently market and health systems failures are keeping them from the women who need them or supporting circulation of poor-quality drugs that put their lives at risk,” said S M Shaikat, Executive Director of SERAC Bangladesh.

“National and local governments, donors, and advocates in Bangladesh must work together to strengthen the market to better deliver quality assured and consistently available maternal health products so women and families can receive the care they deserve,” he added.

The paper outlines actions that advocate in this issue; decision-makers in Bangladesh can take actions to solve persistent problems related to the quality and availability of maternal health care products. These actions include increasing investments to strengthen local manufacturing and regulation of health products, bringing registration and procurement requirements in line with international quality standards, and Strengthening guidelines for proper storage and distribution of maternal health products, including oxytocin, misoprostol, and magnesium sulfate.

While the solutions are not simple, the paper insists that these changes could dramatically accelerate Bangladesh’s efforts to reach maternal health targets pointed out in the Sustainable Development Goals (SDGs). To reach these goals, the paper concludes, “It will be critical to ensure that women have reliable access to lifesaving maternal health products. Strengthening the policy environment in which markets function will be fundamental to sustaining well-functioning markets and improving access.”

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