Designing and assessing medical abortion interventions in health facilities and communities, including women’s perspectives and decision-making processes

Medical abortion is increasingly sought by women throughout the world for a safe, accessible abortion that can be available through private and public health facilities, pharmacies, and other sources in the community. In one recent example, qualitative research by Ipas on use of medical abortion in Bangladesh found that the majority of women report positive experiences, across all sources of the medication, from pharmacies, doctors or clinics. Providers and women both report satisfaction with the use of misoprostol in treatment of postabortion complications in Ipas studies in Nigerian, Kenyan and Ugandan health facilities.

Ipas has evaluated various models for reaching women with safe abortion medications and information. These include provision of medical abortion by private physicians in India and hospital-based nurses in Mozambique and referrals to safe abortion by female community health volunteers in Nepal. The addition of new medical abortion services to existing surgical abortion services in South Africa was evaluated through a large-scale operations research study in South Africa.

Behavioral change communication (BCC) interventions to improve women’s knowledge about where to seek abortion care and their self-efficacy to access services are other approaches evaluated by Ipas researchers, including the use of community intermediaries to refer women to medical abortion services.

Pharmacy workers are a frequent source of medical abortion drugs in many countries. Ipas research in Zambia has identified the improvements and remaining challenges in reaching women with accurate medical abortion dosage information and referrals.