Introducing medical MR in Bangladesh: MRM final report

Hena, Ismat Ara; Rob, Ubaidur; Sultana, Nargis; Hossain, Md. Irfan; Yasmin, Reena; Das, Tapash Ranjan; Ahmed, Farid Uddin

doi:10.31899/rh4.1061

Cited by 6 publications

(21 citation statements)

References 3 publications

(3 reference statements)

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“…Some received other medication, including misoprostol (13,9.2%) or antibiotics (15, 10.6%). Most received information or reassurance (24/142, 16.9%), or were given or advised to take pain medication (37, 26.1%).…”

Section: Resultsmentioning

confidence: 99%

“…9 Unlike prior studies conducted in public sector facilities in Bangladesh, 9 the present study included public sector facilities throughout Bangladesh and a more robust sample size, and tracked MR outcomes for all women who received the service. The success rate of 96% for MR procedures in the present study is similar to rates reported previously in a study conducted in NGO facilities 8 and a smaller study conducted in NGO facilities and public sector facilities in Dhaka.…”

Section: Discussionmentioning

confidence: 99%

“…The success rate of 96% for MR procedures in the present study is similar to rates reported previously in a study conducted in NGO facilities 8 and a smaller study conducted in NGO facilities and public sector facilities in Dhaka. 9 Unlike prior studies conducted in public sector facilities in Bangladesh, 9 the present study included public sector facilities throughout Bangladesh and a more robust sample size, and tracked MR outcomes for all women who received the service. Thus, the results of the study might be more generalizable to regions of Bangladesh with less-developed transportation services and referral networks.…”

Section: Discussionmentioning

confidence: 99%

“…9 The aim of the present study was therefore to investigate the acceptability and feasibility of mifepristone-misoprostol for MR in public sector facilities in each of the six administrative divisions in Bangladesh. 9 The aim of the present study was therefore to investigate the acceptability and feasibility of mifepristone-misoprostol for MR in public sector facilities in each of the six administrative divisions in Bangladesh.…”

Section: Introductionmentioning

confidence: 99%

“…A pilot project examining the use of mifepristone-misoprostol was completed in NGO and public sector facilities, but it included only facilities in Dhaka Division and was not representative of other regions of the country, where access to transportation can be limited. 9 The aim of the present study was therefore to investigate the acceptability and feasibility of mifepristone-misoprostol for MR in public sector facilities in each of the six administrative divisions in Bangladesh.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Mifepristone–misoprostol for menstrual regulation in public sector facilities in Bangladesh

Alam

Lotarevich

Das³

et al. 2017

Intl J Gynecology & Obste

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Mifepristone–misoprostol for menstrual regulation in public sector facilities in Bangladesh

Alam

Lotarevich

Das³

et al. 2017

Intl J Gynecology & Obste

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Using automated voice messages linked to telephone counselling to increase post-menstrual regulation contraceptive uptake and continuation in Bangladesh: study protocol for a randomised controlled trial

Reiss

Andersen²,

Barnard

et al. 2017

BMC Public Health

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BackgroundAdoption of modern contraceptive methods after menstrual regulation (MR) is thought to reduce subsequent unwanted pregnancy and abortion. Long-acting reversible contraceptives (LARCs) are highly effective at reducing unintended pregnancy, but uptake in Bangladesh is low. Providing information on the most effective methods of contraception increases uptake of more effective methods. This protocol describes a randomised controlled trial of an intervention delivered by mobile phone designed to support post-MR contraceptive use in Bangladesh.MethodsThis is a multi-site single blind individual randomised controlled trial. At least 960 women undergoing MR procedures at selected facilities will be recruited after their procedure by female research assistants. Women will be randomised into the control or intervention group with a 1:1 ratio.All participants will receive usual clinic care, including contraceptive counselling and the telephone number of a non-toll-free call centre which provides counselling on MR and contraception. During the 4 months after their MR procedure, intervention participants will be sent 11 recorded interactive voice messages to their mobile phone about contraception with a focus on their chosen method and LARCs. Each message allows the participant to connect directly to the call centre. The intervention is free to the user. The control group will receive no messages delivered by mobile phone. All participants will be asked to complete an in-person questionnaire at recruitment and follow-up questionnaires by telephone at 2 weeks, 4 months and 12 months after their MR. The primary outcome for the trial will be self-reported LARC use 4 months post-MR. Secondary outcomes include LARC use at 2 weeks and 12 months post-MR, use of any effective modern contraceptive method at 2 weeks, 4 months and 12 months post-MR, and contraceptive discontinuation, contraceptive method switching, pregnancy, subsequent MR and experience of violence during the 12 month study period.DiscussionMobile phones offer a low-cost mechanism for providing individualised support to women with contraception outside of the clinic setting. This study will provide information on the effects of such an intervention among MR clients in Bangladesh.Trial registrationTrial registered with clinicaltrials.gov Registration number: NCT02579785 Date of registration: 16th October 2015.

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Implementation considerations when expanding health worker roles to include safe abortion care: a five-country case study synthesis

et al. 2017

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BackgroundAllowing a broader range of trained health workers to deliver services can be an important way of improving access to safe abortion care. However, the expansion of health worker roles may be challenging to implement. This study aimed to explore factors influencing the implementation of role expansion strategies for non-physician providers to include the delivery of abortion care.MethodsWe conducted a multi-country case study synthesis in Bangladesh, Ethiopia, Nepal, South Africa and Uruguay, where the roles of non-physician providers have been formally expanded to include the provision of abortion care. We searched for documentation from each country related to non-physician providers, abortion care services and role expansion through general internet searches, Google Scholar and PubMed, and gathered feedback from 12 key informants. We carried out a thematic analysis of the data, drawing on categories from the SURE Framework of factors affecting the implementation of policy options.ResultsSeveral factors appeared to affect the successful implementation of including non-physician providers to provide abortion care services. These included health workers’ knowledge about abortion legislation and services; and health workers’ willingness to provide abortion care. Health workers’ willingness appeared to be influenced by their personal views about abortion, the method of abortion and stage of pregnancy and their perceptions of their professional roles. While managers’ and co-workers’ attitudes towards the use of non-physician providers varied, the synthesis suggests that female clients focused less on the type of health worker and more on factors such as trust, privacy, cost, and closeness to home. Health systems factors also played a role, including workloads and incentives, training, supervision and support, supplies, referral systems, and monitoring and evaluation. Strategies used, with varying success, to address some of these issues in the study countries included values clarification workshops, health worker rotation, access to emotional support for health workers, the incorporation of abortion care services into pre-service curricula, and in-service training strategies.ConclusionsTo increase the likelihood of success for role expansion strategies in the area of safe abortion, programme planners must consider how to ensure motivation, support and reasonable working conditions for affected health workers.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4764-z) contains supplementary material, which is available to authorized users.

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Introducing medical MR in Bangladesh: MRM final report

Cited by 6 publications

References 3 publications

Mifepristone–misoprostol for menstrual regulation in public sector facilities in Bangladesh

Mifepristone–misoprostol for menstrual regulation in public sector facilities in Bangladesh

Using automated voice messages linked to telephone counselling to increase post-menstrual regulation contraceptive uptake and continuation in Bangladesh: study protocol for a randomised controlled trial

Implementation considerations when expanding health worker roles to include safe abortion care: a five-country case study synthesis

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