Wednesday, June 24, 2015 | News

Meet the expert: Global health systems guidance, curricula and service delivery tools

Katherine L. Turner, MPH, Ipas senior health systems advisor, heads a multi-disciplinary team to develop, review and update Ipas’s global health systems guidance, training curricula and service delivery tools. For over a decade, Turner has led the development of Ipas’s core training and service delivery materials on high-quality abortion-related care. These materials form the basis of Ipas’s and partners’ health systems strengthening and health worker capacity-building activities in countries around the world.

In addition to clinical training curricula on the provision of comprehensive, woman-centered abortion and postabortion care, Ipas materials cover a range of topics—including clinical mentoring, abortion care for young women, values clarification and attitude transformation (VCAT), effective training and providers as advocates for women’s sexual and reproductive health and rights.

Why develop global guidance and training curricula?

We want to ensure that health systems around the world have the capacity to deliver high-quality, evidence-based, clinical training and service provision. Building and strengthening that capacity is essential if we are to prevent the estimated 47,000 deaths that women suffer each year as the result of unsafe abortion. We need to do all that we can to build more people’s capacity to provide safe abortion care, and these training and service delivery tools help achieve that.

What types of curricula and materials are available, and where can they be found?

We recently published the second edition of Ipas’s Woman-Centered, Comprehensive Abortion Care training package. It includes updated, evidence-based clinical guidelines and protocols, new content on abortion for young women, and applies a human rights framework to abortion service delivery guidance.

Other important tools and materials available from Ipas include the Clinical Mentoring and Provider Support for Abortion-Related Care training manual; a values clarification toolkit; and our abortion care for young women training toolkit.

These and many other Ipas curricula and materials are online and can be downloaded free of charge. We encourage widespread use of our curricula—all of which can be adapted as needed to be more clinically and culturally relevant to a particular, local setting.

What learning principles and methodologies are used in these materials?

Ipas curricula and training events are grounded in adult learning and empowerment education principles, participatory, learner-centered methodologies and human rights. Ipas approaches service delivery from a woman-centered perspective. Our training curricula employ effective, time-tested methods and activities that ensure a well-designed training event. Our curricula are a full package—they contain all of the trainers’ instructions, participant and other materials that help ensure that training programs and participants achieve their learning objectives.

What led you to develop curricula and training tools specifically dealing with abortion care for young women?

Young women bear the greatest burden from unsafe abortion. Of the 21.2 million women who have an unsafe abortion each year, almost half are young women between the ages of 15 and 24. Recognizing the critical need to improve service delivery and access to care for young women, I led a global literature review and found an absence of content on young women in the training materials on abortion. And in the sexual and reproductive health and rights literature for young people, there was little mention of abortion. That led us to develop Abortion Care for Young Women: A Training Toolkit. Because research shows that there are actually few differences in the clinical needs of young women compared to adults, the toolkit has more of a focus on advocacy, partnerships and service delivery than clinical issues per se.

What about providers as advocates?

There’s definitely a need for health-care providers to be more engaged in advocacy efforts to create an enabling policy and legal environment for safe abortion care in their settings. To help providers see and understand the unique role they can play in this, we developed the Providers as Advocates for Safe Abortion Caretraining manual. As we note in the manual, providers have the particular strengths, access and status to help achieve real and long-lasting change in policy and health systems. They have personal power as advocates—and we urge them to use it to help create legal and policy environments that are conducive to the provision of safe, legal abortion care.

Is there evidence that these service delivery guidance and materials are getting results?

There is. Each year, these service delivery guidance and materials are used in Ipas-sponsored training events on abortion and related sexual and reproductive health care for thousands of health-care workers. The impressive service delivery figures in Ipas-supported health care facilities attest to the quality of our training and programmatic support. In the last fiscal year alone, nearly 6,000 participants from more than 4,000 Ipas intervention facilities attended an Ipas-sponsored clinical training on comprehensive abortion care; providers trained by Ipas and partners performed nearly 500,000 uterine evacuation procedures, a 36 percent increase from the previous fiscal year.

Our global technical expertise is tapped by ministries of health and other organizations involved in developing national service delivery standards and guidelines for abortion-related care. We have worked closely with ministries of health and other partners in more than 25 countries to produce national standards and guidelines for abortion-related care.

We also experience the impact of our curricula at an individual level. I will never forget the young Pakistani activist who eagerly showed me how she had downloaded our curriculum to her smart phone so that she would always be prepared to lead trainings wherever and whenever they were needed.

In addition, we regularly hear from colleagues in other agencies who are using Ipas curricula and training approaches in their internal organizational training events as well as in their programs with external partners. I have advised and trained numerous international nongovernmental organizations when they included abortion in their global strategies on how to conduct values clarification with their leadership and partners and integrate abortion into existing programs at global, regional and country levels. We helped build their organizational capacity to conduct VCAT and woman-centered abortion care training and programmatic support with their own staff as well as country partners.

Ipas’s technical leadership in health systems strengthening has greatly expanded the number of people around the world who recognize women’s human right to high-quality health care that includes abortion and contraceptive services and the inhumanity of denying women this care. This is foundational work that forms an essential part of our global movement to advance women’s right to high-quality abortion care and results in more services being provided and more women, including young women, receiving the care they need and deserve.

About Us

We work with partners around the world to advance reproductive justice by expanding access to abortion and contraception.

Ipas Sustainable Abortion Care

Our Work

The global movement for legal, accessible abortion is growing. Our staff and partners in countries as diverse as Bolivia, Malawi and India are working to ensure all people can access high-quality abortion care.

Where We Work

The global movement for legal, accessible abortion is growing. Our staff and partners in countries as diverse as Bolivia, Malawi and India are working to ensure all people can access high-quality abortion care.


Our materials are designed to help reproductive health advocates and professionals expand access to high-quality abortion care.

For health professionals

For advocates and decisionmakers


For humanitarian settings

Abortion VCAT resources

For researchers and program implementors