Experts advocate midlevel health care providers' role in improving women's access to safe abortion care

At a recent landmark conference in South Africa, 50 prominent health care providers, public health researchers, policymakers and representatives of technical agencies from around the world 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, midwives, physician assistants and others — are far more numerous than physicians," said Elizabeth Maguire, President of Ipas. "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."

Ipas, a US-based nongovernmental organization focused on improving women's reproductive health, co-sponsored the conference along with IHCAR, the international health research unit of Sweden's Karolinska Institute medical university. The conference — "Expanding Access: Advancing the Role of Midlevel Providers in Menstrual Regulation and Elective Abortion Care" — was the world's first international gathering to focus on the role of midlevel providers in abortion care. It was held December 2-6, 2001, in South Africa's Pilanesberg National Park.

Especially in the world's poorest countries, women's inability to obtain 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, worldwide, 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 decrease significantly until a range of reproductive health care, including postabortion care and elective abortion, is available and accessible to women at the most local level possible," said Professor Staffan Bergström of IHCAR.

Delegates to the Expanding Access conference issued a statement emphasizing that 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 statement cites experience in several countries showing that training and equipping midlevel providers greatly improves women's ability to obtain needed services. The conference developed concrete recommendations for research, policy and programs to promote new actions by governments, nongovernmental organizations, donors and others. In addition, conference delegates left South Africa committed to future collaboration and exchange to promote midlevel providers' involvement in MR and abortion care.

Conference delegates came from 17 countries and included teams from 10 countries, as well as representatives from leading national and international organizations such as the World Health Organization and several governments. Financial support was provided by the Danish Agency for Development Assistance (Danida), the Norwegian Agency for Development Cooperation (NORAD), the Swedish International Development Cooperation Agency (Sida), the Swedish Ministry for Foreign Affairs and the David and Lucile Packard Foundation.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258