Poor quality medicines that endanger the lives of pregnant women

Quality medicines, given at the right time, can save the lives of pregnant women and recently pregnant women and their newborns. The synthesis of new evidence reveals, however, that in many healthcare facilities around the world, women with maternal complications life-threatening are given poor-quality drugs – which put their lives and well-being at serious risk.

A systematic review, authored by WHO Department of Sexual and Reproductive Health and Research staff, including HRP, and associates, published in PLOS ONE, shows that in many low- and middle-income countries, low-quality drugs are used to manage life-threatening maternal conditions.

Maternal mortality

It is equally tragic and unacceptable that so many women, especially those living in low- and middle-income countries, continue to die from causes related to health complications related to pregnancy, childbirth, and the postpartum period. Recent estimates have shown that each day in 2017, about 810 women died from preventable causes related to pregnancy and childbirth.

Preventive with proper treatment

Common life-threatening life complications include postpartum haemorrhage, preeclampsia / eclampsia, and sepsis. With timely and effective care and medication, serious consequences caused by these complications can often be avoided. Uterotonics (drugs used to stop bleeding, especially postpartum hemorrhage), such as oxytocin, are effective in preventing postpartum hemorrhage. Antibiotics administered during childbirth or after birth can prevent or treat sepsis for both women and their newborns. Magnesium sulfate can also help prevent and / or treat eclampsia. These are medical options that are both affordable and effective.

“No specification” and substandard drugs

There are growing concerns about the negative health effects of inferior and counterfeit medicines (also known as ‘out of specification’ medicines), especially in low- and middle-income countries. But a new systematic review shows that low-income versions of these drugs are often provided in many healthcare facilities in low- and middle-income countries. The findings suggest that this problem could contribute to the existence of a large number of severe complications and deaths caused by postpartum hemorrhage, eclampsia, and sepsis in low- and middle-income countries.

A new study showed that almost half (48.9%) of all uterotonic drugs taken failed to assess quality. 1 in 7 samples of injected antibiotics (13%) and 1 in 29 samples of magnesium sulfate (3.4%) were of low quality.

Almost half of the estimated samples have been collected since 2011, indicating that this is an issue of current global importance that requires urgent attention. The study also looked at differences in drug quality between the private and public sectors and found that overall failure rates in the private sector are higher. This finding underscores the crucial need for national procurement authorities or private providers to procure drugs that adhere to WHO retraining or similar stringent requirements.

Quality and dignity

Every woman has the right to quality care before, during and after pregnancy and childbirth. Informed provision of quality medicines, at the right time, is key to ensuring quality and dignified care for women and their newborns.

Healthcare providers also need to have access to high quality medicines to properly care for women. You should also receive appropriate training on how and when to administer these medications. This is crucial because they are working to honor the Hippocratic oath of ‘no harm’.

Mariana Widmer, a scientist from the WHO and HRP, and author of the paper, says: “Healthcare professionals must be able to know that they truly care for women and effectively treat all health complications of pregnancy and childbirth. We need to provide them with training in providing medicines and that medicines are always of good quality.