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

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

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

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.

Download and share these Ipas global curricula and tools

Woman-Centered, Comprehensive Abortion Care training package, Second Edition
Medical Abortion Study Guide and Training Guide, Second Edition
Clinical Mentoring and Provider Support for Abortion-Related Care
Misoprostol Use in Postabortion Care: A Service Delivery Toolkit
Misoprostol for Treatment of Incomplete Abortion: Trainer’s Manual
Clinical Updates in Reproductive Health
Abortion Care for Young Women: A Training Toolkit
Abortion Attitude Transformation: A Values Clarification Toolkit for Global Audiences
Providers as Advocates for Safe Abortion: A Training Manual
Effective Training for Reproductive Health: Course Design and Delivery. Reference Manual and Trainer’s Manual, Second Edition

Visit Ipas University for free, online courses on reproductive health topics, primarily in the developing world, with a focus on safe abortion care and postabortion care.

For more information, contact