The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #59890

Julie Solo, MPH¹, Ines Escandon, MPH², Amy Shire, MPH², Lori Leonhardt, MPH², Joseph Ruminjo, MD, MPH³, and Erika Sinclair³. (1) Independent Consultant, 165 E. 32nd Street, Apt. 7A, New York, NY 10016, (2) EngenderHealth, 440 Ninth Ave., New York, NY 10001, (3) Maternity and Postabortion Care Program, EngenderHealth, 440 Ninth Avenue, 3rd Floor, New York, NY 10001, 212-561-8000, jruminjo@engenderhealth.org

EngenderHealth implemented a three-year project to expand postabortion care (PAC) services in eight countries and to facilitate and support leadership efforts to reduce barriers to services. Interventions included: intensive training on PAC counseling (supportive and family planning-related), infection prevention, clinical treatment of complications and infrastructural improvements. A project evaluation was undertaken in summer 2002 using interviews with in-country staff, key partners, providers and clients; document reviews; and in-depth case studies in three countries. EngenderHealth’s experiences in PAC yielded valuable lessons in program initiation, follow-up and supervision, clinical treatment, humanization of care, linkages to family planning and other reproductive health care, data collection, community involvement and awareness of services, sustainability and coordination. In the Dominican Republic, the Philippines and Uganda, common themes included the strong influence of changed provider attitudes to PAC clients on the quality of care, and the need to improve referrals to and provision of reproductive health services. An initial weakness that the project found critical to address involved identifying only those women treated with MVA as “PAC clients,” such that women treated with D&C were excluded from receiving the same constellation of services. Another key finding included the need for flexibility in training across countries and within sites, e.g. in deciding whom to train, locale and scope of topic areas. Lastly, results found that “it’s not the just the plan, it’s the process”: in order for national plans to be useful for scaling up PAC, there must be participation from those directly involved in providing PAC services.

Learning Objectives:

By the end of this session, participants will be able to
• recognize 3 key challenges to implementing successful postabortion care (PAC) service programs; and
• articulate 3 programmatic considerations in scaling up PAC programs.

Keywords: Post-Abortion Care,

Presenting author's disclosure statement:
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.