Beyond the law: Misoprostol and medical abortion in Dar es Salaam, Tanzania.

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ID: 85109
2020
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Ranked #59 of 124 articles by views in Social science & medicine (1982)

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Abstract
Misoprostol has during the past few years become an important obstetric drug used for different purposes both within and outside hospitals in Tanzania. In this paper, we analyze how misoprostol is perceived, accessed and used off-label as an abortion drug in the city and region of Dar es Salaam. The study took place in Dar es Salaam's three districts from July to November 2015, and had a qualitative explorative approach. We carried out in-depth interviews (42) with the following main categories of informants: women having undergone medical abortion (15), health care workers with experiences from post abortion care (16) and drug vendors (11). Focus group discussions (10) were carried out with young women. A client simulation study was carried out in 64 drugstores across Dar es Salaam assessing the availability of misoprostol and the advice given concerning its use. In addition, shorter qualitative interviews were carried out with representatives of NGOs and public agencies working with sexual and reproductive health issues (17). Our findings reveal that in Dar es Salaam, misoprostol is well known, available and accessed for abortion purposes through drugstores and health providers. Women tend to prefer misoprostol over other abortion methods since it allows for a private, low-cost, safer and less uncomfortable abortion experience. But, while misoprostol facilitates women's agency in the process of seeking abortion, a series of obstacles shaped by a restrictive abortion law and an unregulated pharmaceutical market hinder its safe use. Central obstacles are profit-seeking providers, suboptimal user instructions and poor provider follow-up. In the discussion of the material we draw upon Van der Geest, Hardon and Whyte's concept of the 'social life of pharmaceuticals' and indicate the ways in which misoprostol acts as an agent of change in the social relations connected to abortion.
Reference Key
solheim2020beyondsocial Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Solheim, I H;Moland, K M;Kahabuka, C;Pembe, A B;Blystad, A;
Journal Social science & medicine (1982)
Year 2020
DOI
S0277-9536(19)30671-9
URL
Keywords
global health sexual and reproductive health tanzania medical abortion misoprostol unsafe abortion

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