6 ways to ensure reproductive health-care access during the Ebola outbreak

AP Photo/Sebastien Kitsa Musayi

Democratic Republic of Congo

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Here are six recommendations for health systems and staff to ensure that people seeking essential reproductive health services like abortion and family planning can still safely access care.

These recommendations are drawn from our guidance for health systems. If you’d like to see our full guidance—including detailed infection prevention and control recommendations—please email [email protected].

1. Minimize unnecessary client-provider interactions

Prioritize medication or self-managed abortion as the primary, first-line care method, using digital health tools and community distribution to reduce unnecessary clinic visits.

Dr. Mike Mpoyi, lead for Ipas’s Quality of Care team, explains why reproductive health care must remain part of the Ebola response.

2. Make facility-based abortion care safe

When needed, abortion care can be safely performed in equipped Ebola treatment centers or health-care facilities with appropriate infection prevention and control measures.

3. Ensure access to contraception throughout an Ebola outbreak

Guarantee contraceptive access by providing preferred methods—including long-acting reversible contraception and emergency contraception—along with safe removal services and condoms. Reduce facility visits by distributing 6–12 months of supplies of short-term contraceptives, encouraging self-administered injectable contraception, and offering advance distribution of emergency contraception.

4. Ensure screening and triage don’t delay access to emergency postabortion care (treatment of unsafe abortion complications) and other essential sexual and reproductive health services

Ensure private, confidential triage with trained staff who can accurately distinguish normal causes of bleeding (menstruation, pregnancy-related, or violence) from suspected Ebola, reducing misdiagnosis. Provide rapid, timely testing for Ebola, malaria, and pregnancy to minimize delays in patient care.

5. Support people recovering from Ebola who became pregnant prior to infection

Counsel pregnant individuals recovering from Ebola on the very high fetal/newborn mortality risk (>95%) and support informed decision making, including access to safe abortion services if desired. Recovered patients who conceived before Ebola and are having an abortion should be treated in a health facility using standard and Ebola-specific infection control measures due to transmission risk.

6. Put in place infection prevention and control measures

Ensure health staff are trained in personal protective equipment use, infection prevention and control, case management, and Ebola surveillance. Health facilities and Ebola treatment centers should be adequately supplied with protective equipment and infection prevention supplies—and should have a coordinated supply plan during outbreaks.

Every crisis is different. Our varied solutions recognize that.

Through a variety of different programs and approaches, we’re proving that reproductive health care can be made accessible during an acute crisis and in the years that follow.

Bangladesh

Training health workers in Rohingya refugee camps

Bolivia

Providing health information and care to Venezuelan migrants

Ethiopia

Partnering with community groups and health workers during civil war

Kenya

Partnering with refugees to protect against COVID and ensure health-care access

Malawi, Mozambique and Zambia

Coordinating a response after cyclones and flooding

A large group of people, including adults and children, sit and rest near a green tent on a paved area outdoors. Some are using phones or tablets, while others chat. A few children play or eat snacks. The scene suggests a casual, communal gathering.

Mexico

Expanding abortion access along key migration routes

Ipas team meets with Internally Displaced Persons (IDPs) for needs assessment

Pakistan

In flood-hit Pakistan, Ipas is ensuring reproductive health care

Myanmar

Reaching people through the private sector when public health systems shut down