241229 Benefits of introducing medical methods for abortion related services: The case of Tigray, Ethiopia

Monday, October 31, 2011: 5:06 PM

Ndola Prata, MD, MSc , The Bixby Center for Population, Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA
Amanuel Gessessew, MD , Department of Obstetrics and Gynecology, Mekelle University, Adigrat Town, Ethiopia
Martine Holston, MPH , Venture Strategies Innovations, Venture Strategies Innovations, Berkeley, CA
Rachel Weinrib , Venture Strategies Innovations, Anaheim, CA
Alice Cartwright, MPH , Venture Strategies Innovations, Anaheim, CA
The use of medication for abortion related services posits an opportunity for task shifting to midlevel providers, and service expansion to the lowest levels of the health care system that lack capacity for surgical interventions. A comprehensive abortion care (CAC) program was introduced in Tigray, Ethiopia. Services provided include both surgical and medication, and all of the levels of the health care system were involved, from health post to hospital. The CAC program provided services to women from June 2009 to December 2010 at selected sites. Data from patient records and exit interviews conducted with a subset of participants were analyzed to evaluate the overall feasibility of CAC services and patient satisfaction with the program. The majority of women utilizing services sought safe termination (92%). Since the introduction of medication methods, nurses have provided the majority of services at both hospitals (>95%) and health centers (66%), enabling clinical officers and doctors to focus more advanced surgical interventions and complicated cases. Treatment success rates for newly trained mid-level providers were as expected with medication. Additionally, they were able to follow up and re-assess need for further treatment accurately. Client satisfaction with the program was high: most women (97%) rated their overall experience as “good” (vs. “bad” or “so-so”). These preliminary findings show that introducing medication methods increases access to abortion-related services by allowing providers and or facilities without surgical capacity to provide services.

Learning Areas:
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
1. Review the service delivery structure of this innovative comprehensive abortion care program, with a special emphasis on the role of lower-level providers. 2. Identify the results of the pilot program, including service utilization, referral, contraceptive uptake, and acceptability measures. 3. Discuss the implications of the findings of this pilot program on the provision of services and development of national policies and programs related to safe abortion service provision.

Keywords: Abortion, Access and Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversaw the monitoring and evaluation of the project, and led the data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.