Patent medicine vendors (PMVs)’ report of misoprostol dispensation practices for induced abortion by type of PMV provider
| Variable | Nurse/midwife (n=98) | CHO/CHEW (n=22) | Total (n=120) | P value | |||
| n | % | n | % | n | % | ||
| Dispense misoprostol without prescription* | 97 | 98.9 | 22 | 100 | 119 | 99.1 | 0.535 |
| Misoprostol dosage (μg) dispensed to help bring on a woman’s period if she has missed a period† | <0.001 | ||||||
| <800 | 0 | 0 | 1 | 4.5 | 1 | 0.8 | |
| 800 | 1 | 1.0 | 7 | 31.8 | 8 | 6.7 | |
| 1000–1400 | 5 | 5.1 | 14 | 63.6 | 19 | 15.8 | |
| 1600–2400 | 92 | 93.9 | 0 | 0 | 92 | 76.7 | |
| Suggested route of misoprostol administration‡ | Nurse/midwife (n=98) | CHO/CHEW (n=22) | Total (n=120) | ||||
| Vaginal | 78 | 79.6 | 2 | 9.1 | 80 | 66.7 | <0.001 |
| Under tongue (sublingual) | 84 | 85.7 | 22 | 100 | 106 | 88.3 | 0.169 |
| In cheek (buccal) | 5 | 5.2 | 19 | 86.4 | 24 | 20.2 | <0.001 |
| Approaches for estimating gestational age of pregnancy‡ | |||||||
| Last menstrual period | 98 | 100 | 22 | 100 | 120 | 100 | – |
| Bimanual exam | 60 | 61.2 | 0 | 0 | 60 | 50 | <0.001 |
| Ultrasound scan | 6 | 6.2 | 2 | 9.1 | 8 | 6.7 | 0.49 |
| Does not estimate | 1 | 1 | 0 | 0 | 1 | 0.8 | 0.815 |
| Provide pain management§ | 94 | 96.9 | 21 | 95.5 | 115 | 96.6 | |
| Pain management options provided‡ | |||||||
| Paracetamol | 8 | 8.2 | 0 | 0 | 8 | 6.7 | 0.035 |
| Diclofenac or Feldene | 80 | 82.5 | 21 | 95.5 | 101 | 84.9 | |
| Buscopan | 0 | 0 | 1 | 4.5 | 1 | 0.8 | |
| Available for follow-up consult | 97 | 99 | 22 | 100 | 119 | 99.2 | 0.634 |
| When advised to return‡ | |||||||
| Pain | 68 | 69.4 | 22 | 100 | 90 | 75 | 0.011 |
| Heavy bleeding | 98 | 100 | 22 | 100 | 120 | 100 | – |
| Fever | 64 | 66 | 22 | 100 | 86 | 72.3 | 0.006 |
| Unusual or bad smelling vaginal discharge | 63 | 64.9 | 22 | 100 | 85 | 71.4 | 0.005 |
| Feeling very sick | 64 | 66 | 22 | 100 | 86 | 72.3 | 0.006 |
| If no bleeding or cramping during 2 weeks after taking the pills | 29 | 31.2 | 20 | 90.9 | 49 | 42.6 | <0.001 |
| Services provided for women who report they are still pregnant after taking misoprostol‡ | |||||||
| Take clinical history | 66 | 67.3 | 20 | 90.9 | 86 | 71.7 | 0.019 |
| Conduct a clinical examination | 58 | 59.2 | 4 | 18.2 | 62 | 51.7 | 0.001 |
| Refer to a facility | 63 | 64.3 | 8 | 36.4 | 71 | 59.2 | 0.004 |
| Reassure woman of outcome(s) | 90 | 92.9 | 12 | 54.5 | 103 | 85.8 | <0.001 |
| Proportion of PMVs who report some clients experience complications | 31 | 31.6 | 1 | 4.5 | 32 | 26.7 | 0.009 |
| Services provided when complications arise | Nurse/midwife (n=31) | CHO/CHEW (n=1) | Total (n=32) | ||||
| First aid | 31 | 100 | 0 | 0 | 31 | 96.9 | <0.001 |
| Give other/additional medications | 0 | 0 | 1 | 100 | 1 | 3.1 | <0.001 |
| Refer to a facility | 31 | 100 | 1 | 100 | 32 | 100 | – |
*One PMV was missing data on whether misoprostol was provided by prescription.
†Refers to dosage for abortion.
‡Multiple responses possible.
§Data on pain management were available for a subsample of PMVs (n=119).
CHEW, community health extension worker; CHO, community health officer; PMV, patent medicine vendor.