Moving Evidence to Action: Strengthening Postabortion Care Family Planning in West Africa

  {Photo credit: Sara A. Holtz, Courtesy of Photoshare.}A billboard in Guinea promotes injectable contraceptives: "Depo-Provera: Efficacious, Reversible, Discrete. Contraceptive with a long duration."Photo credit: Sara A. Holtz, Courtesy of Photoshare.

Family planning is an inherent part of quality postabortion care services—allowing women to choose a contraceptive method that best meets their needs helps prevent unintended pregnancies and repeat abortions, and increases their choices for future planning. Yet, despite the evidence that family planning is a crucial part of successful postabortion care services, in many settings, these services are not yet integrated. In other cases, when family planning counseling is provided, contraceptives are not offered simultaneously or at a reasonable cost, limiting women’s access and choice. Providers lack training on how to effectively and sensitively counsel postabortion clients on family planning, and many health facilities lack the resources necessary to offer high-quality family planning services at the point of postabortion care service delivery.

The US Agency for International Development (USAID)-funded Evidence to Action for Strengthened Family Planning and Reproductive Health Services for Women and Girls (E2A) Project—on which MSH is a partner—has taken a leadership role in strengthening and scaling up postabortion family planning services in West Africa, a region with some of the highest maternal mortality and abortion rates in the world.

From 2012 to 2013, E2A conducted an assessment of postabortion care programs in Burkina Faso, Guinea, Senegal, and Togo, with a focus on their family planning component. The assessment covered health systems issues, including: providers’ capacity to offer postabortion care services; the ability of facilities to deliver services with adequate privacy for patients and supervision from management to assure quality; commodity security, including family planning supplies; how health information systems capture data related to postabortion care family planning; and financing of family planning services and costs incurred by clients.

As a project tasked with moving evidence to action, in October 2013, E2A co-hosted a regional meeting on postabortion care in Senegal, where the project disseminated the results of the assessment. Country teams used the findings to develop roadmaps for further strengthening and scaling up postabortion care programs.

E2A is now assisting Burkina Faso and Togo with certain elements of their postabortion care roadmaps. In Burkina Faso, E2A is working closely with the government to develop a national postabortion care strategy that will enable the delivery of high-quality services at scale. In Togo, E2A is improving the quality of postabortion care services at health facilities through provider trainings, ensuring availability of a wide range of contraceptives—including long-acting reversible methods—building effective supervision systems, and reorganizing services to provide contraceptives in the same location as postabortion care to ensure client privacy. E2A also plans to assist Rwanda with systematically scaling up its postabortion care program.

E2A will present findings of the assessment, which can be applied in postabortion care programs globally, at the Third Global Symposium on Health Systems Research in South Africa on October 3, 2014.

The assessment report and four policy briefs derived from the longer report are available in English and French.