Modeling patient access to therapeutic oxytocin in Zanzibar, Tanzania.
BMC Health Serv Res
; 18(1): 645, 2018 Aug 17.
Article
in En
| MEDLINE
| ID: mdl-30119630
ABSTRACT
BACKGROUND:
Our objective is to estimate the effects of therapeutic oxytocin supply chain factors and social determinants of health on patient access to oxytocin in low-income settings using system dynamics modeling. Postpartum hemorrhage (PPH), a major cause of maternal mortality disproportionately affects women in low and middle income countries (LMICs). The World Health Organization recommends therapeutic oxytocin as the frontline uterotonic for PPH management and prevention. However, lack of access to quality therapeutic oxytocin in Tanzania, and throughout Sub-Saharan Africa, continues to result in a high number of preventable maternal deaths.METHODS:
We used publicly available data from Zanzibar and Sub-Saharan Africa, literature review, oxytocin degradation kinetics and previously developed systems dynamics models to understand the barriers in patient access to quality therapeutic oxytocin.RESULTS:
The model makes four basic predictions. First, there is a major gap between therapeutic oxytocin procurement and availability. Second, it predicts that at current population increase rates, oxytocin supply will have to be doubled in the next 30 years. Third, supply and storage temperature until 30 °C has minimal effect on oxytocin quality and finally distance of 5 km or less to birthing facility has a small effect on overall access to oxytocin.CONCLUSIONS:
The model provides a systems level approach to therapeutic oxytocin access, incorporating supply and procurement, socio-economic factors, as well as storage conditions to understand how women's access to oxytocin over time can be sustained for better health outcomes.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Oxytocics
/
Oxytocin
/
Models, Organizational
/
Health Services Accessibility
Type of study:
Prognostic_studies
Aspects:
Determinantes_sociais_saude
/
Equity_inequality
Limits:
Adult
/
Female
/
Humans
/
Pregnancy
Country/Region as subject:
Africa
Language:
En
Journal:
BMC Health Serv Res
Journal subject:
PESQUISA EM SERVICOS DE SAUDE
Year:
2018
Document type:
Article
Affiliation country:
United States