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Ce guide est une source d’informations pour tous ceux qui mettent en œuvre les programmes et les supervisent, pour les conseillers techniques et pour les formateurs qui développent des interventions en vue d’améliorer l’accès aux soins d’avortement et à la contraception. Il propose des stratégies visant à améliorer l’inclusion du handicap dans les politiques, la prestation de service et les interventions de mobilisation de la communauté qui peuvent être adaptées de manière à répondre au plus près des besoins spécifiques et uniques de chaque contexte.
Même si elles représentent un pourcentage considérable de la population, les personnes handicapées1 sont très mal prises en charge et même négligées par les services de santé sexuelle et reproductive, et plus particulièrement par ceux axés sur l’avortement sécurisé et la contraception. Alors que les donateurs, les agents des programmes de santé reproductive, les universités et les activistes commencent à se pencher sérieusement sur les besoins et les droits des personnes en situation de handicap, on ne peut que constater la persistance de lacunes conséquentes dans certains domaines relatifs à l’avortement sécurisé et à la contraception.
This guide is a resource for program implementers and managers, technical advisors and trainers who design interventions to improve access to abortion and contraceptive care. It offers strategies for improving disability inclusion in policy, service delivery and community engagement interventions and can be adapted to meet the unique needs of each context. Recommendations are based on the human rights model of disability, which includes a “twin-track” approach that promotes the empowerment of people with disabilities by creating disability-specific initiatives and integrating disability inclusion in general programming. Active and meaningful participation of people with disabilities throughout all stages of planning, implementing and evaluating abortion and contraceptive care interventions is a core principle underlying each recommendation included in this guide.
Despite being a considerable percentage of the population, people with disabilities are grossly underserved and neglected by sexual and reproductive health services, particularly those focused on safe abortion and contraceptive care. While donors, sexual and reproductive health program implementers, universities and activists are beginning to examine the needs and rights of people with disabilities, considerable gaps persist in the specific areas of safe abortion and contraceptive care.
In 2017, Ipas continued to train doctors, midwives and nurses to safely and respectfully perform abortions and provide counseling on contraceptive options. We continued partnering with community-based organizations—experts on the needs of women and girls in their communities—to teach people about their sexual and reproductive rights. We also continued to educate policymakers about the need for safe abortion, to train police and lawyers on how to uphold women’s rights within their legal systems, and to partner with local groups that advocate for sexual and reproductive rights. Learn about our impact in 2017 and read stories and highlights from the year in our annual report.
This training manual is for clinical mentors and others providing clinical and programmatic support to health-care providers offering abortion-related care. It includes content, activities and materials to improve their knowledge, attitudes and skills for clinical mentoring and provider support.
This report looks at initiatives in four countries—Nigeria, Nepal, Ghana and Zambia—where Ipas is working with governments, communities and other partners to provide clinical and programmatic support to providers and health-care facilities.
This toolkit is designed to help district or national-level clinicians, facility managers or program managers initiate the use of misoprostol as a medical treatment for incomplete abortion or integrate misoprostol into existing postabortion care services.
The Medical Abortion Training Guide, Second Edition, is designed for training providers on the delivery of high-quality, clinic-based, first-trimester medical abortion, particularly in limited-resource settings. It has been updated to reflect the latest evidence from the World Health Organization (WHO) and other important source documents. It includes current clinical evidence addressing the unique needs of young women and recommendations on ways to work with communities to improve information, social support and access to medical abortion.
The Medical Abortion Study Guide, Second Edition, describes the use of medications for first-trimester abortion. It is intended to prepare health-care providers for the in-person skills training and clinical practicum portions of medical abortion training programs. It can also serve as a reference manual during training events and for future reference.
This analysis aimed to estimate the costs and cost- effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. It found that the cost per complete medication abortion was lower than the cost per complete MVA. This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without increasing costs.
This study looked at the socio-economic profile of women seeking abortion services in public health facilities across Madhya Pradesh state and at out of pocket cost accessing abortion services. In particular, it examined the level of access that poor women have to safe abortion services in Madhya Pradesh. Findings highlight that, overall, 57% of women who received abortion care at public health facilities were poor, followed by 21% moderate and 22% rich. Improved availability of safe abortion services at the primary level in Madhya Pradesh has helped meeting the need of safe abortion services among poor, which eventually will help reducing the maternal mortality and morbidity due to unsafe abortion.
In Bangladesh, abortion is restricted except to save the life of a woman, but menstrual regulation is allowed to induce menstruation and return to non-pregnancy after a missed period. MR services are typically provided through the Directorate General of Family Planning, while postabortion care services for incomplete abortion are provided by facilities under the Directorate General of Health Services. The bifurcated health system results in reduced quality of care, particularly for postabortion care patients. This study evaluated the success of a pilot project that aimed to integrate menstrual regulation, postabortion care and family planning services across six Directorate General of Health Services and Directorate General of Family Planning facilities by training providers on woman-centered abortion care and adding family planning services at sites offering postabortion care.
To reduce deaths and disabilities from unsafe abortion, Ethiopia liberalized its abortion law in 2005 to allow safe abortion under certain conditions. This study aimed to measure how availability and utilization of safe abortion services has changed in the last decade in Ethiopia, drawing on results from nationally representative health facility studies conducted in Ethiopia in 2008 and 2014. Using the Safe Abortion Care Model as a framework of analysis, the study found that service availability and quality has increased, but that access to lifesaving comprehensive care still falls short of recommended levels.
This study sought to understand correlates of postabortion contraceptive use at the individual, family and abortion service delivery levels. Potential individual level correlates included contraceptive and abortion history and fertility intentions; family correlates included intimate partner violence (IPV), discordance in fertility intentions, and household decision-making; and service delivery correlates included procedure type and postabortion contraceptive counseling.
This study aimed to compare the effectiveness of a high-intensity model (HIM) and a low-intensity model (LIM) of behaviour change communication interventions in Bihar and Jharkhand states of India designed to improve women’s knowledge and usage of safe abortion services. Although both intervention types improved abortion knowledge, the HIM intervention was more effective.
Abortion is technically legal in Zambia, but the reality is far more complicated. This study describes the process and results of galvanizing access to medical abortion where abortion has been legal for many years, but provision severely limited. It highlights the challenges and successes of scaling up abortion care using implementation science to document two years of implementation. The findings provide a case study of medical abortion introduction in Zambia and offer important lessons for expanding safe and legal abortion access in similar settings across Africa.
The objective of this study was to understand intersections between intimate partner violence (IPV) and other constraints to women’s reproductive autonomy, and the influence of IPV on reproductive health. There were 457 participants included in the analysis and 118 (25.8%) had experienced IPV in the preceding year. IPV was associated with discordance in fertility intentions with husbands/partners and in-laws, with in-law opposition to contraception, with perceived religious prohibition of contraception, and with presenting unaccompanied. Ensuring women’s reproductive freedom requires addressing IPV and related constraints.
Available Here Accès pour toutes : Inclusion des personnes en situation de handicap dans les services d’avortement et de contraception : Guide Lost in the outrage over President Donald Trump’s reinstatement and expansion of the “global gag rule” was fo …
The February 2016 WHO declaration that congenital Zika virus syndrome constitutes a Public Health Emergency of International Concern reacted to the outbreak of the syndrome in Brazil. But the government’s urging to contain the syndrome, which is associated with microcephaly among newborns, is confounded by lack of reproductive health services. Women with low incomes in particular have little access to such health services. The emergency also illuminates the harm of restrictive abortion legislation, and the potential violation of human rights regarding women’s health. Proposed suggestions for remedying the widespread health-care inequities in Brazil are instructive for other countries where congenital Zika virus syndrome is prevalent.