Brahima Bassane | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 20, 2015

Three low-cost, effective maternal health medicines – oxytocin, misoprostol, and magnesium sulfate – can save many women who die each year of postpartum hemorrhage (PPH) and pre-eclampsia and eclampsia (PE/E). Supportive policies, appropriately funded and effectively implemented, are essential for ensuring access to these medicines in health facilities and at the community level.  A favorable policy environment includes: maternal health medicines on national essential medicine lists (EMLs); evidence-based national standard treatment guidelines (STGs) guiding clinical practice; and adequate budgetary support to ensure policies are fully and effectively implemented. In many countries, a supportive policy framework is not in place, or not well-harmonized; for example: essential maternal health medicines may not be included in national EMLs or other key policy documents; and national clinical guidelines, training curricula, and service delivery policies may not reflect the latest evidence-base. In Burkina Faso, a group of stakeholders worked together to add misoprostol on the national EML, and to update the STGs to standardize them in accordance with the 2013 WHO and FIGO guidelines. The committee engaged with national authorities to review the available evidence, and gained their support. In February 2014, the Ministry of Health published the 2014 revision of the national EML which includes misoprostol for prevention and treatment of PPH at all levels of the health system. The updated clinical guidelines will be finalized in 2015.  The policy environment for enabling access to and use of essential maternal health medicines is complex and variable. While there is no single strategy for establishing a supportive policy environment across countries, learning from experiences in different contexts can inform effective action. The experience in Burkina Faso offers a potential model for effective, focused advocacy in countries where misoprostol’s lifesaving benefits are not yet available.