Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #116080

Deborah L. Billings, PhD¹, Julie Solo, MPH², Janie Benson, DrPH³, Tamara Fetters, MPH³, and Barbara Crane, PhD⁴. (1) Research and Evaluation, Ipas Mexico, Pachuca 92, Colonia Condesa, Mexico City, 06140, Mexico, (52-5) 211-7753, debbieb@ipas.org.mx, (2) Independent Consultant, 165 E. 32nd Street, Apt. 7A, New York, NY 10016, (3) Research and Evaluation Unit, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516, (4) Executive Vice President for Policy, Research and Evaluation, IPAS, 300 Market Street, Chapel Hill, NC 27516

Over the past decade, international health and donor organizations, in collaboration with health ministries, have worked to improve the availability and quality of postabortion care (PAC), an important intervention to reduce maternal mortality due to unsafe abortion. However, little systematic documentation of PAC scale-up processes throughout the world has been undertaken. In 2004, we conducted a study in Bolivia, Nigeria, and Mexico to document such processes in an attempt to identify patterns and important components that would be useful for other countries. Sixty five in-depth interviews were conducted with key health ministry and NGO officials, as well as health care providers and researchers, and reports, service statistics, and policies and guidelines were reviewed in order to better understand the history of PAC programs and research in each country and to identify key components of scale-up. While successful PAC scale-up can take different forms and trajectories, the study identified certain key inputs and processes: advocacy and creating an enabling environment; strategic and coordinated expansion; training and follow-up; and monitoring, evaluation, and operations research. Among the outcomes and impact are: more providers able to care for women with abortion complications; increased commitment to delivery of PAC services at different levels of the health system; increased access to comprehensive PAC services; and policy changes. Technical assistance and donor agencies, as well as the policy support provided by international reproductive health conferences, have also played key roles in progress achieved to date in scale-up of PAC programs in Bolivia, Nigeria and Mexico.

Learning Objectives:

• • Understand how conceptual frameworks for the scale-up process can be applied to reproductive health programs;
• • Articulate the key components of scale-up of PAC in Mexico, Bolivia and Nigeria
• • Identify lessons learned from these three country studies that may help other countries in the process of introducing or expanding PAC services.

Keywords: Post-Abortion Care, Sustainability

Related Web page: www.ipas.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commertial supporters WITH THE EXCEPTION OF 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. The author is employed by Ipas. .

Recorded presentation