Report of drugs magnesium Sulphate Misoprostol ACKNOWLEDGMENTS
We are grateful to the Dr.Yasin, Hargeisa Hospital, Berbera Hospital, Burco Hospital, and Adna Aden
Hospital as a whole in Somaliland region for their cooperation, time and provision of information individually
and in focus group that helped the survey team get a better understanding of the medical report in
We wish to thank all those who generously agreed to be interviewed for this important report. Although we
cannot name individuals and groups specifically, we were fortunate that 10 individuals took the time to talk
Finally, we acknowledge with gratitude the support of the International Immigration Office who funded this
project. We thank especially Mr. Mohamed Omer who was both a source of clarity and wisdom.
Eclampsia is presently regarded as an important cause of maternal mortality in low income families. Somaliland, an estimated hundreds women die each year from various complications of pregnancy. Of these, 300 women (nearly 2% of maternal deaths) die annually following eclamptic convulsions, with 99% of these deaths occurring in low and poor income communities in Hargeisa.
Eclampsia is usually a consequence of pre-existing pre-eclampsia, a multisystemic disease associated with raised blood pressure and proteinuria. Primary prevention is the ideal method of reducing the burden of pre-eclampsia and eclampsia in any community. However, to date, aside from contraception to prevent
pregnancies in susceptible women, there is little evidence of effective primary prevention interventions for pre-eclampsia and eclampsia. Thus, secondary prevention, consisting of antenatal care and the early recognition and treatment of preeclampsia and eclampsia remain the principal measures for reducing the burden of the disease in many communities.
The causes of the increase of the death was using old drugs such as phenytoin and diazepam according the prescription doctors. However, it was only in 2008 that strong evidence became available of the effectiveness of magnesium sulphate for women with pre-eclampsia and eclampsia in Hargeisa Hospital
and others in Somaliland. There is now general acceptance that magnesium sulphate is the optimal drug of choice for the treatment of eclampsia according all doctors in Somaliland that we have taken the interviews. Further-more, interview have shown magnesium sulphate to be more effective than phenytoin and
diazepam in preventing recurrent seizures in eclampsia and significantly reducing maternal mortality in rare number. To date, there is evidence that magnesium sulphate is still not available in most regions of Somaliland,
while its availability varies considerably in several others. due to distribution and shortage of the drug. Several barriers to use of magnesium sulphate exist in many regions including lack of distribution of the drug, affordability of the drug, and poor of economic will among lack of awareness in poor families is also
another barriers in Somaliland. Furthermore, Somaliland, magnesium sulphate is perceived to be expensive, even though the drug costs less than $5 per patient in the international market. It is possible that unfavorable local distribution and
marketing mechanisms may have exacerbated the costs of the drug in Somaliland . Clearly, the current limited use of magnesium sulphate for the management of eclampsia despite the evidence of its effectiveness and efficacy is a major difficulty in efforts to reduce maternal mortality in low
income families. We believe that as an essential part of measures to promote safe motherhood in these regions, efforts should be concentrated in the coming years to promote the availability of magnesium sulphate for the prevention and treatment of eclampsia.
Such efforts should include advocacy at national levels to build awareness of the benefits of magnesium
sulphate, public health education to increase women’s access to institutional care during pregnancy and delivery, training and re-training of health care workers on the use of magnesium sulphate, the development and dissemination of related clinical practice guidelines and to address the systemic barriers
that limit the widespread availability of magnesium sulphate in Somaliland. Magnesium sulphate Name of the Hospital Boxes Per box Total amount Remaining
rate of death by region Note: Adna Hospital she give us a letter but she did not mention the death of women Misprostal In many countries, including those with legal restrictions or limited access to abortion, one or both of these drugs are available across the counter in pharmacies. Recent studies have shown that many women, especially in countries where access to abortion services is limited, need more information about the abortion pills. This fact sheet, presented in a question-and-answer format, answers in simple terms questions that women usually ask about ‘abortion pills’. It aims to inform women about drugs that can safely and effectively be used to bring about an abortion, so as to enable them to make informed decisions about termination of pregnancy. In countries where abortion is legally available, it is safest if women use these drugs under the guidance of a health provider, if possible Name of the Hospital Boxes Per box Total amount Remaining Hargeisa Hospital Rate of death by region In conclusion, the prevention and effective management of eclampsia is an important and critical measure to reduce the present high rate of maternal mortality in Somaliland therefore drugs of magnesium should be available hospitals and other clinical were women could get it free charges. Magnesium sulphate has proven to be a critical and important clinical tool to reduce the burden of eclampsia in somaliland.
Hargeisa region is more required magnesium sulphate while other regions require more misoprotol.
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