An Exploratory Study of Drug Sellers’ Knowledge of Misoprostol Use for Medical Abortion in Yogyakarta Indonesia, 2019

Dr Meiwita Budiharsana, Wiji Wahyuningsih & Associate Professor Iwan  Ariawan

Faculty of Public Health – Universitas Indonesia

In 2013, the WHO endorsed misoprostol for reproductive health by including it in the WHO Model List for Essential Medicines, and in the WHO-FIGO guidelines for medical abortion. In Indonesia, misoprostol is licensed only for treating gastroduodenal ulcers. Surgical and medical abortion are illegal in Indonesia, but contradictorily herbal remedies to regulate menstruation are advertised on local television, while ‘massage services’ to induce ‘late menstruation’ are advertised throughout semi-urban areas.  Evidently there is a gap between the legal status of abortion and the services that women access. A 2009 study revealed that misoprostol sales increased by 116% between 2002-2007, indicating growing ‘off-label’ use.  This research sought to assess drug sellers’ knowledge about misoprostol use for medical abortion. A total of 184 pharmacy workers and midwifes from urban Yogyakarta were surveyed in February 2019. Only 14.7% of participants mentioned the importance of the WHO-FIGO guidelines. There were no significant differences in knowledge between midwives and pharmacy workers. Findings indicate that the criminalisation of abortion has led to growing demand for misoprostol as an off-label drug for medical abortion. Of concern is that most misoprostol sellers have insufficient knowledge about the safe and effective use of misoprostol for medical abortion.


Meiwita Budiharsana is a medical doctor and Public Health Professor at the Department of Population and Biostatistics, Faculty of Public Health – Universitas Indonesia. She has a PhD in Public Health from UCLA – USA. She has worked for more than 30 years on gender and reproductive and sexual health and rights

Wiji Wahyuningsih is a data analyst with a Bachelor of Public Health degree from the Faculty of Public Health – Universitas Indonesia. Her research interests cover family planning, social health insurance and reproductive health and rights.



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