Rebecca Stoltzfus Dineen, MS¹, Amy Rial, RN/MPH², Tsigue Pleah, MD³, Yolande Hyjazi, MD⁴, Paul S. Nebié, MD⁵, Blandine Thiéba, MD⁶, and Cheryl Treacy-Lenda¹. (1) Africa Office, JHPIEGO, 1615 Thames street, Baltimore, MD 21231, (2) Africa Office - JHPIEGO, The JHPIEGO Corporation, Browns Wharf, 1615 Thames St, Baltimore, Maryland, MD 21211, (410) 614 0582, arial@jhpiego.org, (3) Learning Performance and Support Office - JHPIEGO, Learning Performance and Support Office - JHPIEGO, Browns Wharf, 1615 Thames St, Baltimore, MD 21231, (4) Faculte De Medecine-Pharmacie-Odonto-Stomatologie, Université de Conakry, c/o M Magette Barry, SGTT BP 3345, Conakry, Guinea, (5) JHPIEGO, Burkina Faso, Immeuble sis côté ouest de la Bank of Africa, Avenue de la Résistance du 17 mai Secteur N° 4 01 BP 5654, Ouagadougou, Burkina Faso, (6) La Cellule de Recherche en Santé de la Réproduction (CRESAR), 01 BP 1330, Ouagadougou, Burkina Faso

Maternal mortality rates in the West African Countries of Burkina Faso and Guinea are among the highest in the world and unsafe abortion accounts for approximately 20% of that rate in Burkina Faso and for 17% in Guinea. This problem is compounded by a high, unmet need for Family Planning (FP) services in both countries, as evidenced by low contraceptive prevalence rates for modern FP methods. In 1997, JHPIEGO began strengthening PAC services in National Hospitals in Ouagadougou, Burkina and Conakry, Guinea. By combining research, advocacy and training, and generating enthusiasm among key stakeholders, the program was able to transfer the processes and learning materials used in the National Hospitals to 10 regional hospitals and 18 district hospitals in Burkina, and to 8 regional hospitals and 7 district and urban health centers in Guinea, enabling the Ministries of Health to provide PAC services nationwide. The most significant result of this rapid expansion has been the increased integration of FP services into standard PAC services. Average annual percentage of MVA clients counseled about FP in each of the 5 years of the project were striking —between 91% and 100%—and these high levels are being sustained over time. This increase demonstrates the impact of expanding the health system’s capacity to meet more women’s FP needs: now women in urban and rural regions of these countries have access to modern FP methods. Increased access gives women more control over their reproductive health, contributing, in turn, to lower maternal mortality rates.

Learning Objectives:

• - Understand the need for rapid scale up of quality postabortion care (PAC) services in West Africa.
• - Describe the components of the PAC model and how it was applied to rapidly scale up infection prevention, manual vacuum aspiration, and family planning (FP) services in Burkina Faso and Guinea.
• - Explain five-year PAC program results from Burkina Faso and Guinea.

Keywords: Post-Abortion Care, Family Planning

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am an employee of JHPIEGO Corp., an affiliate of The Johns Hopkins University. The programs described in this presentation were conducted under Training in Reproductive Health by employees and consultants of JHPIEGO.