Advance Distribution of Misoprostol for Self-Administration: Expanding Coverage for the Prevention of Postpartum Hemorrhage has been developed to provide organizations and agencies with a step-by-step guide to participating in the improvement and scale-up of existing misoprostol distribution programs for prevention of postpartum hemorrhage (PPH). It is intended for use by organizations that have not previously implemented misoprostol programming, as well as by Ministries of Health (MoHs) and consortiums of implementing partners interested in developing a unified plan for expanding coverage. This guide recommends scaling misoprostol programming as an integrated part of a comprehensive PPH prevention strategy within the national safe motherhood program. It assumes that in many contexts implementers will not be working in isolation, but will need to partner with others to ensure uterotonic coverage at all births.


Lindsay Grenier, Jeffrey Smith, Sheena Currie, Stephanie Suhowatsky, Jhpiego Corporation, an affiliate of The Johns Hopkins University, 2013