Evaluating the Community-Based Distribution of Misoprostol for Early Abortion in Pakistan

Abstract

With nearly 13% of maternal deaths being attributed to unsafe abortion there is a need to implement new strategies to improve access to safe services. As developing regions and legally restricted areas lead these numbers, further evidence must be presented demonstrating tailored and actionable strategies for these settings. In Pakistan abortion is legally restricted and the country continues to face a high burden of maternal death and disability, much of which is directly or indirectly attributable to unsafe abortion. The community-based distribution of misoprostol for early abortion has the potential to reduce harm from unsafe abortion in Pakistan and other low-resource settings where abortion is legally restricted. This study employed a multi-methods approach to evaluate this intervention in Sindh, Pakistan and consisted of a logbook review, interviews with lay providers, and in-depth interviews with program beneficiaries. Our results suggest that the community-based distribution of misoprostol is an effective and promising strategy for improving access to safe abortion care. Efforts to implement or strengthen similar programs appears warranted.