Availability and Use of Oxytocin in Health Facilities in Nepal

Abstract

Introduction: Although maternal mortality is declining over the past 15 years, it is still high in Nepal. Postpartum haemorrhage is the leading cause of maternal deaths in Nepal. Oxytocin is one of the emergency drugs, which prevent and manage postpartum haemeorrhage, listed in essential drug list, and supplied to hospitals and Primary Health Care centers in Nepal. The study aimed to assess availability, storage condition, prescriber’s knowledge and practice of Oxytocin in Nepal.

Methods: A descriptive cross-sectional explorative study was conducted in 40 health facilities of 10districts. Multiple methods–observation, interviews, store records and delivery charts analysis-were used to collect data. The respondents of the study (health facility in-charges, service providers and storekeepers) were interviewed with semi-structured questionnaire. The collected data was entered into MS-Excel and analyzed using SPSS version 17.

Results: Oxytocin was available throughout the year in 35.5% of health facilities among them only 8.3% of health facilities stored Oxytocin in refrigerator. In-charges, service providers, were not aware of recommended temperature for Oxytocin storage. Similarly, 40.7% of the service providers used Oxytocin for prevention and management of postpartum haemorrhage, 31.9% and 27.4% of service providers used Oxytocin for augmentation and induction respectively.

Conclusion: In some districts, the medicine was not available throughout the year. Majority of service providers were not aware of recommended indications to induction and augmentation. There should be a serious effort to orient the service providers about rational use of Oxytocin and store to maintain the efficacy of the drug.