Postabortion Care

	Family Planning: A Key Component of Post Abortion Care – September 2009 [PDF, 153KB] This consensus statement by FIGO, ICM, ICN, and USAID stresses the importance of family planning to the practice of post abortion care.

Each year in the developing world, an estimated 210 million women become pregnant. Approximately 15 to 20 percent of these pregnancies will end in miscarriage and 67,000 women will die from complications related to unsafe abortion.  This represents13 percent of all pregnancy  related deaths.  Millions more women suffer serious illness and infertility. To address these severe health problems and to reduce maternal death, USAID funds postabortion care (PAC) programs that comprehensively address women's needs through three core components:

• Emergency treatment for complications of spontaneous or induced abortion
  
  
• Family planning counseling and services, and depending on disease prevalence and available resources, STI evaluation and treatment, and HIV counseling and or referral for testing
  
  
• Community empowerment through community awareness and mobilization

Postabortion care is a programmatic priority for USAID's Bureau for Global Health and is a key intervention in the pathway to maternal survival and the reduction of unplanned pregnancies that may result in repeat abortion. While USAID supports treatment for abortion-related complications, USAID does not support abortion as a means of family planning nor does USAID provide abortions in any circumstances. USAID does not finance the purchase or distribution of manual vacuum aspiration equipment for any purpose.

• USAID Postabortion Care Resources
• Technical Meetings
• Postabortion Care Community Mobilization
• Technical Briefs
• Research and Modeling Papers on Postabortion Care

USAID Postabortion Care Resources

• Postpartum Family Planning ToolKit
  This toolkit provides a comprehensive collection of best practices and evidence-based tools and documents on postpartum family planning (PPFP) developed through the ACCESS-FP Program.
  
  
• Meeting Health Care Needs of Women Experiencing Complications of Miscarriage and Unsafe Abortion: USAID's Postabortion Care Program - July/August 2007 [PDF, 119KB]
  This article provides information on the history of USAID’s postabortion care program, the current PAC strategy, the Global PAC Resource package, and results from focus countries involved in the current PAC strategy.
  
  

• Download the April 2007 Report of the Postabortion Care Technical Advisory Panel [PDF, 333KB]

  Report of the Postabortion Care Technical Advisory Panel - April 2007 [PDF, 333KB]
  This report's purpose is to assist USAID in the ongoing and future scale-up of safe and effective PAC programs worldwide for women experiencing complications related to miscarriage and incomplete abortion.
  
  
• USAID Postabortion Care Strategy Paper - October 2004 [PDF, 762KB]
  The overall goal of USAID's PAC strategy is to reduce maternal mortality, morbidity, and repeat abortions.
  
  • III. Core Components of the PAC Model
  • Appendix C: USAID Global and Country Results Framework, Indicators, and Commentary for Use
    (see page 35) [PDF, 762KB]
    

Technical Meetings

• Postabortion Care (PAC) Technical Meeting - Moving Forward with Postabortion Care: Lessons Learned from Five Postabortion Care Focus Countries – March 18-19, 2009
  View presentations and related publications from this two-day meeting, co-sponsored by USAID's Postabortion Care Working Group, the Population Council’s FRONTIERS Program, and the ACQUIRE Project, led by EngenderHealth.

Postabortion Care Community Mobilization

• Mobilizing Communities for PAC Services – Spring 2005 [PDF, 2MB]
  This article from The Michigan Fellows Newsletter, published by the USAID-funded Populations Fellows Programs, describes the implementation of Bolivia's first PAC community mobilization model.

Technical Briefs

• Decentralization of Postabortion Care in Senegal and Tanzania – March 2008 [PDF, 144KB]
  In developing countries, PAC programs are frequently available only in urban or regional health facilities, placing rural women at greater risk for mortality and morbidity from complications because they lack access to services. To improve access, USAID has worked with two focus countries, Senegal and Tanzania, to decentralize PAC activities.
  
  
• Postabortion Family Planning Benefits Clients and Providers – November 2005 [PDF, 559KB]
  Provision of family planning methods is a central feature of postabortion care. Ensuring reliable onsite availability of family planning methods for all clients following abortion or miscarriage can result in benefits for clients, providers, and programs.
  

Research, Assessments, and Modeling Papers on Postabortion Care

General Research

• Assessment of the Progress of the PAC Initiative in Francophone Africa – April 2008 [PDF, 709KB]
  This multicentric study documents the progress of introducing and implementing PAC in Burkina Faso, Guinea, Mali, Niger, Senegal, and Togo. The objectives of this study included assessing the situation; describing the process of the introduction, integration, and decentralization of PAC; and analyzing the successes and obstacles involved in the process of integration and institutionalizing PAC. The summary of this report is in English, the body is in French.
  
  
• What Works: A Policy and Program Guide to the Evidence on Postabortion Care – February 2007
  This paper analyzes socio-demographic and reproductive health characteristic data of women receiving PAC services from 24 studies in 14 countries and paints a varied picture of women presenting for PAC services. This paper was prepared by the Futures Group’s Policy Project after an extensive research and literature review was conducted for the publication of the research compendium of the Global PAC Resource Package entitled “What Works: A Policy and Program Guide to the Evidence on Postabortion Care."

Decentralization of PAC Services to Health Center and Health Post Levels

• Assessment of the Extension of Postabortion Care Services in Senegal – September 2007 [PDF, 551KB]
  This paper documents the existing model of decentralized PAC services to 23 health centers and 300 health posts in Senegal. Lessons learned and challenges encountered are documented to inform national and global replication and scale-up efforts.
  
  
• Assessing the Feasibility, Acceptability and Cost of Introducing Postabortion Care in Health Centers and Dispensaries in Rural Tanzania – July 2007 [PDF, 700KB]
  This report documents the process of decentralizing PAC to health centers and dispensaries in Tanzania and prospectively assesses the feasibility, effectiveness, and cost. Information on changes in provider knowledge, attitudes and practices; experiences of postabortion clients and their perceptions of the new services; changes in community attitudes and knowledge about abortion complications; effectiveness of varied types of referral networks; and additional resources that would be required of the Ministry of Health to support the introduction of these services is discussed.

Postabortion Family Planning

• Family Planning: A Key Component of Post Abortion Care – September 2009 [PDF, 153KB]
  This consensus statement by FIGO, ICM, ICN, and USAID argues that all women should receive counseling and family planning services after any abortion – spontaneous or induced – irrespective of the pregnancy termination or evacuation procedure used, and stresses the importance of family planning to the practice of post abortion care.
  
  
• Is There Value in Adding a Follow-Up Visit to Postabortion Care? – June 2006 [PDF, 203KB]
  This modeling paper reports the findings of a USAID-funded review that responds to the question of whether there is benefit in adding a follow-up visit to the current one visit model for PAC services. The paper offers evidence of the benefits to women receiving services, progress toward development goals, and potential cost savings.

Cost Projection Models

• Cost-Effective Interventions to Reduce Maternal Mortality in Senegal: The Role of Postabortion Care and Family Planning - An Application of the Allocate Model – June 2006 [PDF, 298KB]
  The Allocate Model, funded by USAID, is an interactive, user-friendly computer tool designed to assist countries in developing integrated national reproductive health plans with realistic budgets. It's objectives are to help planners understand the relationship between funding levels and safe motherhood, postabortion care, and family planning programs and to demonstrate the effects of resource allocation on a variety of national indicators. This paper reports the findings of the use of the Allocate Model in the development of Senegal's national reproductive health strategic plan.