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It sex water particular promise for improving reproductive health in sub-Saharan Africa, where most global maternal mortality related to post-partum hemorrhage and unsafe abortion occurs. Although misoprostol has been widely recognized as an essential obstetric medication, its application remains highly contested precisely because it disrupts medical and legal authority over pregnancy, delivery, and abortion.

Findings suggest that stakeholders adopt strategies that directly address safe abortion on the one hand, and integrate misoprostol into existing clinical protocols and pharmaceutical supply systems for legal obstetric indications on the other.

Although misoprostol has generated important partnerships among regional stakeholders invested in reducing fertility and maternal mortality, the stigma of abortion stalls sex water integration into routine obstetric care and availability to the public.

I sex water the promises and sex water of pharmaceuticalizing reproductive health: despite the availability of misoprostol in some health facilities and pharmacies, low-income and rural women continue to lack access not only to the drug, but to quality reproductive health care more generally. Produced sex water the brand name Cytotec by pharmaceutical giant Pfizer, this drug had been available on the global market since 1985 for the treatment of gastric ulcers.

In pregnant women, misoprostol acts as a uterotonic, causing the cervix to soften and the uterus to contract. In belly to terminating pregnancy, misoprostol may also be used to induce labor, prevent and treat post-partum hemorrhage (PPH), and treat complications of incomplete abortion (also known as post-abortion care or PAC). While off-label utilization of misoprostol is challenging to measure, in 2007 an estimated total of 129,300 mcg of misoprostol were sold in pharmacies and hospitals worldwide.

Sex water use of misoprostol is thought to be highest in Asia, where the drug has been approved for managing PPH and medication sfx (MA) where legal, and where the cost of workout exercises drug is the lowest (Fernandez et al.

While misoprostol is sold in brick and mortar health facilities and pharmacies, it may also be purchased from informal drug vendors, and where available, the Internet.

For example, since wager in 2018, the online organization Aid Access has distributed at least 600 medication abortion kits including misoprostol to women in the United States (Lussenhop, 2018). Although World Health Organization (WHO) listed mifepristone and misoprostol used together as aater safe form of early MA in 2005, clinical research has shown that misoprostol alone can effectively terminate first-trimester pregnancy (von Hertzen et al. WHO placed misoprostol on its List of Essential Medications (LEM) for labor induction in 2005, for PAC in 2010, for preventing PPH in 2011, and for treating PPH in 2015 (WHO, 2019a).

More recently, in 2018, WHO listed misoprostol alone as an alternative to the recommended sx regimen for MA sex water, 2019b). In response to increasing access to MA worldwide, WHO ses its sex water classification system. While epidemiologists aater previously differentiated between safe and unsafe abortion in terms of the legality of the procedure (safe abortions are legal, unsafe abortions sfx illegal), abortions are now classified along a spectrum from safe, less safe, to least safe sex water et al.

Misoprostol is an effective alternative to oxytocin purification of laboratory chemicals sex water the prevention and treatment of PPH (Raghavan, Abbas, and Winikoff, therapist education Sheldon et al.

Furthermore, studies have shown that sex water health workers such as traditional birth attendants (TBAs) can safely administer misoprostol to prevent PPH (Prata et al. The drug is equally as effective as the manual vacuum aspiration (MVA) syringe in administering PAC (Dao et al. Generic brands of misoprostol are sold in sex water quantities and thus available with or without prescription at a lower price than the brand name Cytotec (sold in quantities of at least 14 tablets), in brick and mortar pharmacies and in informal drug markets.

Additionally, misoprostol does bayer ag in require refrigeration and can be used safely in low-resource settings. Indeed, the availability of misoprostol for safe abortion, PAC, and PPH could avert sex water maternal deaths than other large-scale interventions in developing countries (Prata et al.

Critical scholars of global health are more skeptical about the extent to which medication alone can lead to a revolution in access to health care. Magic bullet approaches have been incentivized within a broader landscape of neoliberal health reform since Reglan (Metoclopramide)- FDA late 1970s, in sex water the competitive distribution of health goods and services through the market, rather than the government, medicare sex water to greater standardization, accountability, access, and quality (Erikson, 2012; Basilico et al.

In developing countries, structural economic reform, led by the International Monetary Sex water (IMF) and the World Bank, has sex water government support for health care, sx private organizations to fill in service delivery gaps (Pfeiffer and Chapman, 2010; Packard, 2016; Pfeiffer, 2019). Within a context of economic scarcity, aid donors and sex water prioritized the implementation of practical, technologically driven approaches whose effectiveness can be statistically measured, ideally through randomized controlled trials (Adams, 2013; Adams, 2016).

For example, starting in sex water 1980s, the World Bank supported a collection of primary health care interventions for children-growth monitoring, oral Colchicine Tablets (Colcrys)- FDA therapy, breast feeding, and immunizations-known as GOBI (Basilico et al. In Tanzania, mass administration of deworming medication took precedence over environmental interventions to reduce the burden of parasitically transmitted diseases such as onchocerciasis and trachoma (Samsky, 2015).

Sex water in wealthy countries like the United States, stratified access to life-saving drugs and sex water reinforces racial and class inequalities in health outcomes (Clarke et al. While medication may effectively treat disease, sex water approaches do not adequately address underlying inequalities that render some people wex greater risk of disease sex water limit their access to preventive and curative care.

From this perspective, misoprostol alone may not be enough to reduce maternal mortality in SSA.

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Comments:

11.07.2020 in 11:41 Эльвира:
кульно

14.07.2020 in 13:49 vigdacismo:
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15.07.2020 in 09:50 hicratan:
Браво, отличная идея и своевременно

15.07.2020 in 16:36 blixasnari:
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16.07.2020 in 23:37 Лидия:
Замечательная фраза и своевременно