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Sunday, August 25, 2013
Population Council releases report on post-abortion careStaff Report
ISLAMABAD: The Population Council has released a report, titled ‘Post-Abortion Care in Pakistan: A National Study’, to outline the gaps in the quality of post-abortion care following unsafe abortion procedures, societal stigmas and inequities in the healthcare system, the burden of post-abortion complications and the role of private and public sectors in ensuring access to care.
As an update to a study completed in 2002, the report provides recommendations for promoting safer post-abortion care, expanding access to high-quality and affordable family planning services and contraception, and building capacity among healthcare providers to help achieve these goals.
The report was released during a meeting at a local hotel in Islamabad in which National Health Services, Regulations and Coordination Minister Saira Afzal Tarar was the chief guest and keynote speaker. A panel of experts from leading national institutions and professional organisations joined speakers from the Population Council and the Guttmacher Institute.
Attended by representatives from the government, donor organisations, health professionals, academics, NGOs and members of the civil society, the report presented an opportunity for experts to share their views on topics shaping reproductive health and socio-economic climate in Pakistan and determine the best way forward for helping women. Saira Afzal Tarar spoke of the urgent need for policies and planning at the highest levels of the government to tackle the issues raised in the report. She also stressed to focus on actual implementation of the plans and policies.
“It gives us a great cause for concern that nearly 700,000 women in Pakistan needs treatment annually for complications of induced or spontaneous abortion,” said Tarar. “We do not have many facilities and adequate equipment if complications occur. Lack of well-trained staff, stigma and financial constraints are the barriers to good service delivery.” She suggested that nurses, lady heath visitors (LHVs) and other midlevel health providers should be trained in the provision of post-abortion care.
Population Council Country Director Dr Zeba A Sathar and report co-authors Dr Gul Rashida, Dr Zakir Shah and Iram Kamran presented the study findings. Report co-author and Guttmacher Institute Vice-President Dr Susheela Singh participated via videoconference. Maternal Health Programme-Research an Advocacy Fund (RAF) Programme Manager Sarah Hall commented on the report and gave rationale of funding the study.
Following the presentation, the report was discussed by a panel of experts, which included Rawalpindi Medical College Gynaecology & Obstetrics Professor Dr Rizwana Chaudhry, Packard Foundation Senior Programme Adviser Dr Yasmeen Sabeeh Qazi, Gynaecologist & Obstetrician Dr Lubna Hassan, Gynaecologist & Obstetrician Dr Ghazal Mehmood, National Committee for Maternal & Neonatal Health (NCMNH) President Dr Sadiqua N Jafarey and Society of Obstetricians and Gynaecologists of Pakistan (SOGP) President Dr Tasneem Ashraf articulated their perspectives with concluding remarks.
The study found that in 2012, nearly 700,000 women in Pakistan went to health facilities for treatment of complications resulting from spontaneous abortions or induced abortions using unsafe methods or with the assistance of an unskilled provider. While safe procedures for post-abortion care were found to be more widely used in 2012 than they were in 2002, health facilities still rely on unnecessarily invasive procedures such as dilation and curettage (D&C). Additionally, many facilities do not have adequate equipment and supplies to provide quality care for complications and a majority are not equipped to provide around-the-clock services to manage severe complications. Lastly, the private sector plays an important role in the provision of care, as more than 60% of all cases were treated by private sector health providers.
According to the study, in Pakistan, 25% of women would like to avoid or delay pregnancy but are not using contraception and therefore are at risk for unintended pregnancy. As a result, many women resort to induced abortion to end unintended pregnancies. The current law in Pakistan permits abortion to save a woman’s life and to provide ‘necessary treatment’.
Due to these legal restrictions and the lack of clarity among women and healthcare providers in interpreting the law, women may be forced to seek abortion by untrained providers. The resulting morbidity and mortality places a heavy burden on women, their families, communities and the national health system, the study added.
The study was funded by the Research an Advocacy Fund (RAF), UK Department for International Development (DFID) and the Australian Agency for International Development (AusAID) and was conducted by the Population Council in collaboration with the Guttmacher Institute and the National Committee for Maternal and Neonatal Health. The Population Council and the Guttmacher Institute collected data through two quantitative surveys and several qualitative methods, including surveys of 266 health facilities and 102 healthcare professionals; in-depth interviews of 44 women who had an induced abortion in the past six months; and 10 focus groups involving women with at least three children to gain an understanding of community norms regarding abortion and post-abortion care.
The authors unanimously reached on five key recommendations i.e. improve the quality of post-abortion care and expand the use of safer, World Health Organisation-recommended treatment methods such as manual vacuum aspiration (MVA) and medication abortion; ensure that health facilities in the public and private sectors are equipped with the technologies needed to provide the full range of post-abortion care; establish a national consensus on provider training and capacity building and promote continued advocacy; ensure facilities that provide post-abortion care are prepared to offer a full range of contraceptive services onsite or in their immediate vicinity 24 hours a day, seven days a week and develop post-abortion care protocols that are in accordance with the latest scientific developments and are distributed widely to service providers.
Courtesy www.dailytimes.com.pk