PHA-Exchange> Midlevel health care providers' role in abortion care

[Aviva]

From: <Merrill.Wolf.WolfM at ipas.org>
>
> December 27, 2001  At a recent landmark conference in South Africa,
> 50 prominent health care providers, issued a call to action in support of
advancing the role of midlevel health care providers in menstrual regulation
and safe abortion care.
>
> Worldwide, midlevel health care providers  including nurses, mid-
> wives, physician assistants and others  are far more numerous than
> physicians.They also tend to be much closer to women and in many cases are
their only contact with the formal health care system. As such, these
providers
> have a critical role to play in reducing deaths and injuries of women
> from unsafe abortion, which is a major cause of maternal mortality
> worldwide."
>
> Especially in the world's poorest countries, women's inability to ob-
> tain high-quality medical care for abortion or abortion complications
> leads many to rely on unqualified practitioners or to try dangerous
> folk remedies. The World Health Organization estimates that, world-
> wide, more than 70,000 women die every year as a result of abortions
> performed by unqualified personnel in unhygienic conditions, or both.
> Experts agree that these deaths  and the millions of injuries that
> also result from unsafe abortion  are wholly preventable.
> The deaths and suffering of women from unsafe abortion will not de-
> crease significantly until a range of reproductive health care  in-
> cluding postabortion care and elective abortion  is available and
> accessible to women at the most local level possible.
>
It is essential for health systems to create policy and service delivery
environments that enable menstrual regulation and/or abortion care to be as
accessible as possible to women.
> The experience in several countries shows that training and equipping
midlevel providers greatly improves women's ability to obtain needed
services.
>
Conference statement:
>
> Worldwide, nearly 80,000 women die every year and millions more suf-
> fer serious complications and disabilities from unsafe abortion,
> which is wholly preventable. Even in countries where abortion-related
> maternal mortality is low, women still often lack access to abortion
> care and other reproductive health services that they want and need.
>
> Increasing the accessibility of menstrual regulation (MR) and/or safe
> abortion care is a key strategy in reducing unacceptably high rates
> of maternal mortality and morbidity, and in ensuring women's ability
> to exercise their sexual and reproductive rights. Since midlevel
> health care providers are more numerous and tend to be closer to
> women than physicians, they have a critical role to play in meeting
> women's needs for postabortion care, MR and  in circumstances where
> it is legal  termination of pregnancy.
>
> Experience in Bangladesh, South Africa and several other countries
> demonstrates that authorizing, training and equipping midlevel pro-
> viders to deliver MR and/or abortion care can make an important dif-
> ference in improving women's access to needed services.
>
> Creating an enabling environment to expand and strengthen midlevel
> providers' scope of practice is especially important in situations
> where they are the principal or only health care providers in the
> communities where women live.
>
> As health care providers, researchers, policymakers and representa-
> tives of technical agencies, we, the participants in the first-ever
> international meeting exploring midlevel providers' role in MR and
> abortion care, strongly believe:
>
> . that women deserve prompt access to high-quality MR and/or abortion
> care,
> . that it is essential for health systems to create policy and ser-
> vice-delivery environments that enable MR and/or abortion care to be
> as accessible as possible to women, and
> . that women's access to such care can be greatly enhanced by better
> integrating these services into midlevel providers' scope of prac-
> tice.
>
> All of us who are committed to enhancing women's health and lives
> have a responsibility to facilitate women's access to the reproduc-
> tive health care they want and need, including menstrual regulation
> and abortion care.
>
> This conference has strengthened our commitment to fulfill this
> critical mandate  an effort in which midlevel providers clearly play
> a key role.  As a network of concerned professionals, we call on gov-
> ernments, health policymakers, nongovernmental organizations, inter-
> national organizations, donors and others to take action in support
> of advancing the role of midlevel providers in menstrual regulation
> and safe abortion care.
>