New guidelines from WHO on health worker roles in abortion care

Wednesday, July 29, 2015

Health Worker Roles in providing safe abortion care and post-abortion contraception is now available online from the World Health Organization (WHO). 

The guidelines provide recommendations for expanding of health worker roles in the provision of safe abortion care, the management of complications of abortion, including postabortion care and emergency obstetric care, and for postabortion contraception provision. The new guidelines illustrate that evidence-based interventions for safe abortion and postabortion care in early pregnancy can be provided at the primary health-care level and by a wide range of non-specialist providers, including midwives, nurses, auxiliary nurse midwives, pharmacists and lay health workers.

“…Nearly 22 million unsafe abortions take place every year; these continue to contribute significantly to the global burden of maternal mortality and morbidity. Among the many barriers that limit access to safe abortion care, the lack of trained providers is one of the most critical. It is estimated that the global deficit of skilled health-care professionals will reach 12.9 million by 2035. Such shortages are especially critical in regions of the world that also have a high burden of unsafe abortion and related mortality,” states WHO in the executive summary.

“The WHO guidelines on task shifting have come out at an opportune time. I hope the evidence presented by the WHO guidelines will facilitate the Indian Gynecological and Medical associations to endorse a recent proposal by the Health Ministry to include mid-level providers in the provision of abortion,” says Vinoj Manning, executive director of the Ipas Development Foundation (IDF), a partner organization of Ipas. Manning was part of the development process for the new guidelines.

“Task shifting is an important and timely public health strategy; one that can greatly improve the quality of abortion care in a number of settings and contexts,” adds Dr. Laura Castleman, Ipas medical director. The guidelines fill a void in the evidence for provision of abortion care with suggestions for specific cadres of health workers and which tasks are appropriate for each one. Users will also be able to use an interactive webpage soon that will filter recommendations by cadre and task.

“This is really a breakthrough tool for health systems, program managers, policymakers and NGOs, such as Ipas. At Ipas, we’ve been training midlevel providers to safely provide abortion care since the 1990s and we’re proud to have contributed to the global evidence. Unsafe abortion and lack of access to quality care remains a neglected problem and this evidence for involving multiple types of health workers—that can be turned into practice in a number of settings—will only serve to ensure that women and girls get the care they need,” says Traci Baird, Ipas executive vice president.