The availability of Misoprostol in pharmacies and patent medicine stores in two Nigerian cities

Context: As the glaring inequity in maternal death ratios becomes more apparent between countries in the Northern and Southern Hemispheres, health experts try to achieve a reduction in their own nations' pregnancy-related deaths. Perhaps no research holds as much potential to make a difference in the developing world as research conducted on the gynaecological indications of misoprostol. The media tend to portray that misoprostol is widely available among private sector pharmaceutical distributors in Nigeria, yet evidence is lacking to that effect. Objective: To examine the availability of misoprostol in two major Nigerian cities, in order to explore the supply side of misoprostol six months after the drug's registration for management of postpartum hemorrhage in Nigeria. Methods: This was a cross sectional descriptive study involving proprietors, pharmacists or vendors of pharmaceutical and patent medicine outlets in two Nigerian cosmopolitan cities, Lagos and Abuja. They were interviewed using a semi-structured questionnaire in May and June 2006 in Abuja and Lagos respectively. Result: Misoprostol was not well-known or widely available in either city. Out of nearly six hundred shops surveyed, only 18 (4%) reported misoprostol cost information, indicating they had stocked the drug in the past, and only 15 of these (3%) currently had misoprostol on their shelves. When pharmacists and drug sellers who stocked misoprostol were asked what it was recommended for, treatment or prevention of postpartum hemorrhage was not mentioned. Conclusion: Concerted efforts to disseminate scientific information and educate all levels of health care providers should accompany new policy and protocol changes to achieve maximum national impact. Key words: Availability, pharmacists, postpartum haemorrhage, misoprostol, Nigeria.