Although abortion is categorically illegal in the Philippines, a predominantly Roman Catholic country, annually approximately 400,000 Filipino women resort to the procedure under clandestine and unsafe conditions. This often results in complications and hospitalization. Hospital management focuses on medical treatment; patients are often discharged without family planning information or referral for other reproductive health services. Service providers are often biased against induced abortion patients. Further, there were no written policies and guidelines specifically for the provision of postabortion care services.
AVSC International, in collaboration with the DOH, responded with a postabortion care project--although past administrations refused to address abortion, fearing reprisals from the Catholic Church. The “Prevention and Management of Abortion and its Complications" (PMAC) project involved several different strategies at site and institutional levels.
DOH members, providers, professional societies, international organizations, and NGOs formed a Technical Working Group to formulate PMAC policy. At eight public and private pilot sites, providers were trained in PMAC counseling, clinical management (including Manual Vacuum Aspiration), and infection prevention. Service site spaces were upgraded, and quality assurance and improvement systems are in place. Despite apprehension about the program, there are early positive results--especially with the use of the MVA (shortened hospital stays and improved staff relationships). Now more women choose FP methods prior to discharge. Important lessons learned include situating postabortion care within the existing health system, working early on policy formulation, and allowing service sites to implement the component/s of PMAC that are most comfortable to them as a starting point.
Learning Objectives: At the end of the session, the participant will be able to: 1. Describe the process/steps to introduce a postabortion care program in a country. 2. Identify some key partners/groups in establishing a postabortion care program in a hostile environment. 3. Discuss the lessons learned from the initial experience of PMAC implementation in the Philippines.
Keywords: Post-Abortion Care,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.