Table 3.

Summary of facilitators and barriers to the availability and use of oxytocin, ergometrine, and MgSO₄

Health system level	Facilitators	Barriers
Government/Regulatory	Essential medicine included in the national EML	● STGs for pre–eclampsia/eclampsia and PPH prevention and treatment were not consistent, updated, or disseminated ● Ergometrine and syntometrine recommended as first–line for PPH prevention and treatment ● Formulations not licensed by national drug authority ● No drug registration system
Pharmaceutical supply System	Essential medicine listed on the national EML	● Lack of adequate and suitable procurement and forecasting system in place ● No stringent quality assurance process, especially storage conditions to maintain drug efficacy ● Inadequate infrastructure led to stock–outs in health facilities
Health facility	Essential medicines found in health facilities	● Wide variation in the level of availability between different countries ● Lack of stringent requirements for maintenance of equipment used to store medications ● Lack of adequate diagnostic testing equipment to make correct diagnosis
Health professional	Health professionals aware of recommended first–line medicines for PPH and pre–eclampsia/eclampsia prevention and treatment	● Uncertainties in the practical administration of essential medications ● Lack of continuous professional education for health providers ● Lack of equipment to safely administer medications