New IJGO Supplement: Quality of care for abortion-related complications

IJGO-WHO Abortion supplement

IJGO is delighted to announce the publication of a World Health Organization (WHO) and joint UN special Human Reproduction Programme (HRP)[1] supplement containing insights from the WHO and HRP Multi-Country Study on Abortion-related morbidity (MCS-A) across 11 African countries.

Assessing Post-Abortion Care in Sub-Saharan Africa

Seven papers utilise secondary data analysis to assess the quality of care for abortion-related complications in facilities in Sub-Saharan Africa. The wealth of data generated provide a unique opportunity to assess the provision and experience of care for abortion-related complications in Sub-Saharan Africa, especially in countries with restrictive abortion laws.

“This supplement shows how far we still have to go in ensuring quality, respectful post-abortion care for all; it also proves how much we can learn when we commit to working together. Across 11 countries, knowledge has been gained and research capacity has been strengthened. A stronger research community is better able to listen, ask and answer questions, working together for a future where every woman and girl achieves the highest standard of sexual and reproductive health and rights.”

– Özge Tunçalp, Medical Officer at WHO and HRP.

Complications due to unsafe abortions are an important cause of morbidity and mortality in many Sub-Saharan African countries. Despite the burden these complications represent for health services, information on the provision and quality of care for abortion and abortion-related complications in many settings across Sub-Saharan Africa is lacking.

To try to fill this important evidence gap, WHO/HRP conducted a cross-sectional study in 210 health facilities in partnership with local research institutes between February 2017 and April 2018. The findings span both clinical provision of care and quality of care from the women’s perspective, exploring how this is experienced differentially by those living in vulnerable situations such as adolescents and women accessing care in insecure environments.

A multipronged approach including self-care, clinical care, task sharing, human rights, and an enabling legal environment is needed to deliver high-quality abortion and post-abortion care, including access to family planning, but there is still considerable progress to make. Immediate action needs to be taken by healthcare providers and policy makers.

Read the MCS-A WHO supplement here

Improving the provision and experience of abortion care 

Three key areas are highlighted here:

  1. To reduce the number of women facing abortion-related complications, access needs to be increased to high-quality abortion services in all levels of the healthcare pyramid.
  2. Evidence-based quality improvement approaches need to be implemented across Sub-Saharan Africa to improve the quality of post-abortion care.
  3. Identification and implementation of multifaceted interventions can address broader contextual reasons for the high incidence of severe complications including harmful provider behaviours and beliefs, health system constraints, and lack of women’s empowerment.

The authors of the editorial of the supplement, Professors Seni Kouanda and Zahida Qureshi, conclude with these hopeful words:

While we still face many challenges and obstacles to ensuring access to high-quality abortion and post-abortion care for all women, we believe that efforts such as the MCS-A in Sub-Saharan Africa, Latin America, and the Caribbean represent an important step forward. We hope that the work presented throughout this supplement will help inspire innovations and insights to help fulfil women’s reproductive rights.

 

[1] The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP)