Using evidence—and on-the-ground expertise—to improve abortion care quality

Friday, March 3, 2017

clinicians talking

When it comes to ensuring women and girls receive high-quality abortion care, Ipas combines the latest evidence with lessons learned in collaboration with health professionals globally to produce broadly relevant and useful clinical recommendations.

“Ipas’s clinical staff, trainers and partners are continuously learning from the unique challenges and opportunities they encounter in Ipas-supported health facilities—often in low-resource settings—across Africa, Asia and Latin America,” says Dr. Dalia Brahmi, medical editor of Ipas’s Clinical Updates in Reproductive Health. “We synthesize scientific research and programmatic innovations from diverse settings to form Ipas’s clinical recommendations.”

Ipas’s 2017 Clinical Updates provide the most up-to-date recommendations on comprehensive abortion care in English and Spanish (with French coming soon). Continuous revisions are based on a thorough review of published scientific evidence and ongoing feedback from professionals who use the recommendations in training, advocacy and as a reference guide.

“I use the Ipas Clinical Updates in order to provide evidence-based, woman-centered reproductive health care in different countries around the world,” says Dr. Manisha Kumar with Médecins Sans Frontières in the Democratic Republic of Congo. “I use them to stay up to date in my clinical practice as well as for developing protocols and training staff so women will receive the best possible care.”

Three ways Ipas's Clinical Updates are improving care for women

1. Timeliness: Ipas’s recommendations are consistent with the World Health Organization (WHO) 2012 and 2014 guidance on abortion care, with the addition of evidence published since the last WHO update.

“Our annual revision process means we’re able to incorporate the latest research findings as soon as they are published,” explains Dr. Emily Jackson, Ipas’s senior clinical consultant who works on the Clinical Updates. “Research and clinical practice in the abortion-care field are quickly evolving, so annual revisions are incredibly helpful for our staff and partners to be able to provide women and girls with top-quality care.”

2. Relevant in low-resource settings: Health facilities operating with few resources have unique needs. “Ipas draws on extensive networks of clinicians and trainers to help us tailor our recommendations so they’re useful and easy to implement for providers working to serve even the hardest-to-reach women,” Jackson says.

For example, facilities may struggle to maintain misoprostol product quality with proper packaging and storage conditions, may need to resort to an alternative method of instrument sterilization when supplies run low, or may only be able to obtain a certain concentration of lidocaine for use in pain management. All these potential challenges, flagged by colleagues in low-resource settings, are addressed in the 2017 version of Ipas’s Clinical Updates.

3. Clinical questions answered while evidence builds: Despite rapidly accumulating evidence on safe abortion care, there are often still gaps. To provide high-quality services, Ipas-supported clinicians and trainers often need practical information that isn’t yet available in global guidance documents.

“For example, a paracervical block is broadly recommended for pain management, however the ideal technique is still being determined,” Jackson explains. “Ipas uses the best available evidence to provide our programs with reliable guidance, while highlighting areas for future research so these questions can be answered definitively.”


Read and share the new Clinical Updates:

Also available in Spanish:

For comments, questions or feedback on the Clinical Updates, please email