Post-abortion drugs in short supply

Health facilities that are meant to offer post-abortion care in the country are experiencing shortages of essential drugs required to provide for the service.

Research conducted by Tsungai Chipato of the University of Zimbabwe's Obstetrics and Gynaecology, in conjunction with Guttmacher Institute, the ministry of Health and Child Care (MoHCC) and the Women's Action Group showed that 55 percent of the health facilities had run out of misoprotol — an essential medicine for post-abortion care.

Thirty-five percent of the facilities had run out of blood for transfusions, while another 35 percent had no intravenous antibiotics.

It was further observed that tertiary hospitals have the highest level of stock outs of the drugs.

"The most affected institutions are the central hospitals. They have more shortages than the smaller places yet they receive the most complicated cases," said Chipato when he presented the research findings.

It was also found that a fifth of public facilities asked women to pay for post-abortion care prior to treatment even though these facilities are supposed to provide the service at no cost to women.

"Due to the shortage of the drugs you find out that a patient comes with a complicated case needing intravenous antibiotics and they have to buy the drug at a private pharmacy.

"If they don't have money, they die," Chipato said.

He bemoaned the use of expensive procedures that carry greater risks of further complications than medically recommended methods such as manual vacuum aspiration and misoprostol.

Chipato said half of the hospital facilities designated under national guidelines to provide manual vacuum aspiration did not have the equipment to do so.

"A substantial proportion of first trimester post abortion cases are treated using surgical procedures not recommended by the World Health Organisation or national guidelines for this type of care," he said, adding that government should adequately fund central hospitals so that they are never short of anything.

"Government has no excuse for not funding central hospitals when they keep on flying people out for treatment. They should adequately stock essential medicines and equipment for post-abortion care," he said.

It was also recommended that nurses should also be trained and supported to provide both misoprostol and manual vacuum aspiration.

According to the research, the MoHCC has made efforts to increase access and improve post-abortion care in order to reduce maternal mortality but the ongoing economic insecurity has limited the health systems' capacity to provide these services.

The ministry's deputy director of Reproductive Health Margaret Nyandoro confirmed that the post-abortion drugs supplies are very low.

While at least 40 percent of women who had an abortion in Zimbabwe experience complications that required medical treatment, only half of women with complications received the treatment they need.

Of the estimated 25 200 women receiving facility-based post abortion care in 2016, about half were treated for complications related to unsafe abortions.

Half of these cases were treated at district hospitals and one third at larger central hospitals.

Among women treated for post-abortion complications, in 2016, 78 percent had mild or moderate complications and 19 percent had severe complications

Three percent died or nearly died from complications.

Women experiencing complications from unsafe abortions in 2016, faced delays in obtaining post-abortion care. On average, nearly two full days elapsed between experiencing complications and receiving completed treatment