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

Abstract #116112

Lauren Pesso, S.M. Shahidullah, MD, Humaira Ahmed, MD, Nazneen Sultana, MD, and Abu Jamil Faisel, MD. EngenderHealth, 440 Ninth Avenue, New York, NY 10001, 212-561-8534, lpesso@engenderhealth.org

Complications of unsafe and incomplete abortion are a main cause of maternal morbidity and mortality in Bangladesh. Since 2000, EngenderHealth has been introducing, expanding, and improving postabortion care (PAC) services in Bangladesh. Building on successes in other countries and the results of an assessment conducted in 2000, EngenderHealth developed action plans for PAC introduction. From 2001 to 2004, comprehensive PAC was introduced and expanded in seven private and 25 public facilities (under the Ministry of Health and Family Welfare).

Interventions included developing a training program, curriculum, and national standards; equipment provision; materials development; and advocacy to link PAC to family planning (FP) and secure a local supply of manual vacuum aspiration (MVA) equipment. Strategic involvement of medical colleges and the obstetrics and gynecology society helped gain support and improve referral linkages.

A review of 15 project sites in 2004 found that 64% of PAC clients were treated with MVA; many providers have shifted from using dilation and curettage to manage complications. Ninety percent of PAC clients received FP and other counseling, and 74% received a method. Infection prevention and record keeping improved. By training local trainers, the program has built long-term local capacity.

Findings show that comprehensive PAC can be brought to scale in the various health sectors of Bangladesh, despite significant systems-wide obstacles. Given sufficient training, motivation, supplies and support, providers in the Health, FP, and private sectors are enthusiastic to improve and expand PAC services. Government and provider buy-in is essential to the program's successful introduction and sustainability.

Learning Objectives: Participants attending this session will be able to

• identify 3 key factors of success in scaling up postabortion care (PAC) services in the public and private sectors in Bangladesh;
• note the role of key actors in the institutionalization of referral services; and
• name two areas in which advocacy played a pivotal role.

Keywords: Post-Abortion Care,

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 commercial supporters.

Recorded presentation