Making the List: The Role of Essential Medicines Lists In Reproductive Health

Hutchings, Jane; Neroutsos, Keith; Donnelly, Kathleen M.

doi:10.1363/3620510

Cited by 7 publications

(10 citation statements)

References 2 publications

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“…The presence of oxytocin, misoprostol, and magnesium sulfate, in correct dosages, on the World Health Organization (WHO) and national essential medicines lists 2 …”

Section: Introductionmentioning

confidence: 99%

Are national policies and programs for prevention and management of postpartum hemorrhage and preeclampsia adequate? A key informant survey in 37 countries

Smith¹,

Currie²,

Cannon

et al. 2014

Glob Health Sci Pract

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“…The presence of oxytocin, misoprostol, and magnesium sulfate, in correct dosages, on the World Health Organization (WHO) and national essential medicines lists 2 …”

Section: Introductionmentioning

confidence: 99%

Are national policies and programs for prevention and management of postpartum hemorrhage and preeclampsia adequate? A key informant survey in 37 countries

Smith¹,

Currie²,

Cannon

et al. 2014

Glob Health Sci Pract

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“…Reproductive health advocates have argued for the inclusion of reproductive health drugs and supplies, including equipment for manual vacuum aspiration, into countries' essential drugs list. 34 A third challenge is ensuring the quality of postabortion care services once they have been introduced. Special training strategies are required for providers and their supervisors so that emergency services, counseling and family planning services continue to be emphasized after training.…”

Section: What's Required For Scale-upmentioning

confidence: 99%

Postabortion Care: Going to Scale

RamaRao

Townsend²,

Diop³

et al. 2011

IPSRH

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Millennium Development Goal 5 aims to reduce the 1990 level of maternal mortality by 75% by 2015. The major direct causes of maternal mortality are well documented: Most women die from severe bleeding, infections, eclampsia, obstructed labor or the consequences of unsafe abortion. 1 Evidence-based interventions exist to address each of these causes. Safe abortion where legal, family planning and postabortion care-the management of the patient once she presents to a health provider with complications caused by either a miscarriage or an induced abortion-are interventions that provide options for women to ensure that every child is a wanted child. Given that 13% of maternal deaths result from unsafe abortions, 2 postabortion care has the potential to prevent maternal deaths. Postabortion care is especially relevant in countries where abortion is restricted, but is useful even in countries where abortion is legal but access to safe services is limited.For the past two decades, efforts have been made to design service delivery models that incorporate the specific elements that postabortion care programs should provide. 3,4 Currently, there are two main models-one developed by the PAC Consortium and one developed by the United States Agency for International Development (USAID); there are significant overlaps between the two. The model advocated by the PAC Consortium includes five elements: partnerships between communities and service providers; client-centered counseling at appropriate times during service delivery; treatment with emphasis on pain management; family planning; and links to reproductive and other health services. 3 The USAID model has three components: emergency treatment; family planning and STI and HIV services; and community empowerment via community awareness and mobilization. 4 Countries have been able to draw upon the two models when designing and implementing postabortion care services. Created to facilitate scale-up and increase access to postabortion care, the models provide guidance on how services could be designed and delivered; how postabortion care could be integrated with other health services, including family planning; and how to develop the partnerships required with the communities that are the ultimate beneficiaries of service improvements.The ultimate goal for postabortion care programs is scaling up-increasing service coverage by replicating the pilot program or moving a given service from its pilot orientation and integrating it into the existing health system. In order for a service model to go to scale, it must demonstrate feasibility, efficacy and potential for sustainability, in addition to being client-oriented. Furthermore, the new service must be written into policy documents; service guidelines and standards must be developed and deployed; providers must be trained; and facilities and staff must be reoriented in providing this new service. Scaling up is vitally important because it improves access for women in need of postabortion care, which ultimately contributes to...

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“…This is particularly problematic and often grossly unethical in emergency situations when medicines are needed immediately, regardless of ability to pay. A simplified emergency care EML would ensure the safety, efficacy, and availability of life-saving medicines [17] . It would serve to guide an essential component of emergency service delivery, leading to a more reliable drug supply and improved prescribing patterns, likely with improved patient outcomes and cost-effectiveness [4] , [8] .…”

Section: Introductionmentioning

confidence: 99%

Essential medicines for emergency care in Africa

Broccoli

Pigoga

Nyirenda

et al. 2018

African Journal of Emergency Medicine

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ObjectivesEssential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury.MethodsWe undertook a multi-step consensus process to establish an EML for emergency care in Africa. After a review of existing literature and international EMLs, we generated a candidate list for emergency care. This list was reviewed by expert clinicians who ranked the medicines for overall inclusion and strength of recommendation. These medications and recommendations were then evaluated by an expert group. Medications that reached consensus in both the online survey and expert review were included in a draft emergency care EML, which underwent a final in-person consensus process.ResultsThe final emergency care EML included 213 medicines, 25 of which are not in the 2017 WHO EML but were deemed essential for clinical practice by regional emergency providers. The final EML has associated recommendations of desirable or essential, and is subdivided by facility level. Thirty-nine medicines were recommended for basic facilities, an additional 96 for intermediate facilities (e.g. district hospitals), and an additional 78 for advanced facilities (e.g. tertiary centres).ConclusionThe 25 novel medications not currently on the WHO EML should be considered by planners when making rational formularies for developing emergency care systems. It is our hope that these resource-stratified lists will allow for easier implementation, and will be a useful tool for practical expansion of emergency care delivery in Africa.

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Making the List: The Role of Essential Medicines Lists In Reproductive Health

Cited by 7 publications

References 2 publications

Are national policies and programs for prevention and management of postpartum hemorrhage and preeclampsia adequate? A key informant survey in 37 countries

Are national policies and programs for prevention and management of postpartum hemorrhage and preeclampsia adequate? A key informant survey in 37 countries

Postabortion Care: Going to Scale

Essential medicines for emergency care in Africa

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