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Community-Based Distribution of Misoprostol for the Prevention of ...

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INFORMED CONSENT (VERBAL)<br />

(INSTRUCTIONS FOR THE INTERVIEWERS: Please read <strong>the</strong> following statement to in<strong>for</strong>mant be<strong>for</strong>e asking<br />

any question <strong>for</strong> <strong>the</strong> interview)<br />

(Greet <strong>the</strong> person—Hello/Salam/Aasalaamu Aleikum). My name is .........................……. I am working with<br />

<strong>the</strong> Mayer Hashi project <strong>of</strong> EngenderHealth, an international NGO. I hope you know that a pilot project on<br />

misoprostol use during home delivery to prevent postdelivery excessive vaginal bleeding has been<br />

implemented at eight upazilas <strong>of</strong> Tangail District during <strong>the</strong> period <strong>of</strong> November 2008-June 2009, by<br />

EngenderHealth in collaboration with <strong>the</strong> Directorate General <strong>of</strong> Health Services and Directorate General <strong>of</strong><br />

Family Planning. We are conducting a study to understand why some women have taken <strong>the</strong> misoprostol<br />

drug immediately after delivery <strong>of</strong> <strong>the</strong>ir baby and why some women did not take it. Also, we would like to<br />

know individual opinions and suggestions about <strong>the</strong> distribution and follow-up system <strong>of</strong> misoprostol tablets<br />

use at <strong>the</strong> community levels. Findings <strong>of</strong> this study will help <strong>the</strong> government make policy decisions to reduce<br />

maternal deaths and to achieve MDG 5 in Bangladesh.<br />

We have collected in<strong>for</strong>mation from <strong>the</strong> field worker’s register that indicates you have received <strong>the</strong><br />

misoprostol tablets but did not take three tablets immediately after delivery <strong>of</strong> your baby to prevent excessive<br />

postdelivery vaginal bleeding. I hope you can remember it. I would like to ask you a few questions about this<br />

issue. The interview will take around 30 to 45 minutes <strong>of</strong> your time. The risk <strong>of</strong> your participation in this study<br />

is minimal. Your participation in this interview is completely voluntary and <strong>the</strong>re is no penalty if you decide not<br />

to participate or refuse to respond to any question; you can stop <strong>the</strong> interview at any time. You will not receive<br />

any direct benefit or money <strong>for</strong> your participation in <strong>the</strong> interview.<br />

The interview will be conducted in a private setting that provides auditory privacy. Your responses will be kept<br />

confidential. We will not share your in<strong>for</strong>mation with anyone in your community, nor will we identify you in<br />

any way when <strong>the</strong> study findings are published. If you permit, <strong>the</strong> discussion between you and me will be tape<br />

recorded with voices only, to help us recall what has been discussed when preparing <strong>the</strong> report. Only <strong>the</strong><br />

researchers will have access to your responses, which <strong>the</strong>y will utilize to prepare <strong>the</strong> report.<br />

You may ask any questions or clarifications be<strong>for</strong>e giving your consent <strong>for</strong> <strong>the</strong> interview. You may also contact<br />

Dr. Halim (01712094176) or Mr. Mahboob (8112334/36) with any questions be<strong>for</strong>e or after <strong>the</strong> interview.<br />

Do you have any questions? Yes _____ No_____<br />

If you do not have any questions, do I have your permission to continue? Yes _____ No_____<br />

Investigator’s Statement<br />

I, <strong>the</strong> undersigned, have explained <strong>the</strong> consent <strong>for</strong>m to <strong>the</strong> woman in a language she understands. She has<br />

given her consent to conduct <strong>the</strong> interview.<br />

__________________________________<br />

Signature <strong>of</strong> Investigator<br />

___________________<br />

Date<br />

42 <strong>Community</strong>-<strong>Based</strong> <strong>Distribution</strong> <strong>of</strong> <strong>Misoprostol</strong> <strong>for</strong> <strong>the</strong> <strong>Prevention</strong> <strong>of</strong> PPH<br />

Mayer Hashi project

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