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Postpartum haemorrhage is a leading cause of maternal death in sub-Saharan Africa. Although WHO recommends use of oxytocin for prevention of postpartum haemorrhage, misoprostol is increasingly used owing to advantages in shelf life, ease of use, storage, and potential for sublingual administration. We assessed the comparative efficacy of oxytocin and sublingual misoprostol for prevention of postpartum haemorrhage during labour.

BackgroundPoor access to essential medicines remains a barrier to improvement of health in low-income countries. The maternal mortality rate from post-partum haemorrhage (PPH) in Uganda is one of the highest in the world. Uganda launched a misoprostol rollout programme for prevention of PPH in 2009, before WHO added it to the Essential Medicines List. We assessed the rollout programme in Uganda.