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Cost-effectiveness of provider training approaches: A comparison of intensive training vs. orientation for postabortion care (PAC) in Bolivia

C. Christopher Bross, MA, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516, 919-960-5569, brossc@ipas.org, Janie Benson, MPH, Division of Health Systems Research, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516, Victor Huapaya, MD, Training and Service Delivery Improvement, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC NC 27516, and Tamara Fetters, MPH, Research and Evaluation Unit, Ipas, 300 Market St, Ste 200, Chapel Hill, NC 27516.

International development organizations often pursue intensive and costly approaches for transferring skills and technologies to health providers. Training programs are particularly intensive when providers, including gynecologists, nurses, nurses’ assistants and administrative personnel are trained as a team in courses that often last five days or more. Each type of provider possesses different skill sets and may achieve competency with varying degrees of practice. For several years, Ipas has also pursued a less-intensive postabortion care (PAC) with manual vacuum aspiration (MVA) orientation approach for providers with high-level reproductive health skills. A retrospective study was conducted in Bolivia to determine the level of skill transfer, taking into account other institutional and environmental factors that influence the utilization of skills following the training event. Under the multi-day training model, 151 providers of all levels were trained in comprehensive PAC services. Under the orientation model, Ipas conducted small group sessions lasting less than one day for 145 gynecologists and physicians. This study, in which providers trained during the two years prior to the study were interviewed, will show the effectiveness of each approach, looking at the cost of each training model and the level of competency, measured by indicators such as whether or not providers have performed MVA procedures and how confident they are in performing the procedure. The study also includes other factors that affect performance, such as institutional support, availability of instruments and supplies, and national policies for sexual and reproductive health.

Learning Objectives: Following the session, the participant will be able to

Keywords: Post-Abortion Care, Training

Related Web page: www.ipas.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Ipas is an international NGO working in the field of reproductive and sexual health and rights. Ipas is also the manufacturer and distributor of manual vacuum aspiration instruments.
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 a Program Coordinator in the Programs Unit of Ipas, an international NGO working in the field of reproductive and sexual health and rights. Ipas is also the manufacturer and distributor of manual vacuum aspiration instruments.

U.S. and International Perspectives on Abortion: Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA