Experts advocate midlevel health care providers' role in abortion care ---------------------------------------------------------------------- Experts Advocate Midlevel Health Care Providers’ Role in Improving Women’s Access to Safe Abortion Care December 27, 2001 At a recent landmark conference in South Africa, 50 prominent health care providers, public health researchers, poli- cymakers and representatives of technical agencies from around the world issued a call to action in support of advancing the role of midlevel health care providers in menstrual regulation and safe abor- tion care. “Worldwide, midlevel health care providers including nurses, mid- wives, physician assistants and others are far more numerous than physicians,” said Elizabeth Maguire, President of Ipas. “They also tend to be much closer to women and in many cases are their only con- tact with the formal health care system. As such, these providers have a critical role to play in reducing deaths and injuries of women from unsafe abortion, which is a major cause of maternal mortality worldwide.” Ipas, a US-based nongovernmental organization focused on improving women’s reproductive health, co-sponsored the conference along with IHCAR, the international health research unit of Sweden’s Karolinska Institute medical university. The conference “Expanding Access: Ad- vancing the Role of Midlevel Providers in Menstrual Regulation and Elective Abortion Care” was the world’s first international gather- ing to focus on the role of midlevel providers in abortion care. It was held December 2-6, 2001, in South Africa’s Pilanesberg National Park. Especially in the world’s poorest countries, women’s inability to ob- tain high-quality medical care for abortion or abortion complications leads many to rely on unqualified practitioners or to try dangerous folk remedies. The World Health Organization estimates that, world- wide, more than 70,000 women die every year as a result of abortions performed by unqualified personnel in unhygienic conditions, or both. Experts agree that these deaths and the millions of injuries that also result from unsafe abortion are wholly preventable. “The deaths and suffering of women from unsafe abortion will not de- crease significantly until a range of reproductive health care in- cluding postabortion care and elective abortion is available and accessible to women at the most local level possible,” said Professor Staffan Bergström of IHCAR. Delegates to the Expanding Access conference issued a statement (at- tached) emphasizing that it is essential for health systems to create policy and service delivery environments that enable menstrual regu- lation and/or abortion care to be as accessible as possible to women. The statement cites experience in several countries showing that training and equipping midlevel providers greatly improves women’s ability to obtain needed services. The conference developed concrete recommendations for research, policy and programs to promote new ac- tions by governments, nongovernmental organizations, donors and oth- ers. In addition, conference delegates left South Africa committed to future collaboration and exchange to promote midlevel providers’ in- volvement in MR and abortion care. Conference delegates came from 17 countries and included teams from 10 countries, as well as representatives from leading national and international organizations such as the World Health Organization and several governments. Financial support was provided by the Danish Agency for Development Assistance (Danida), the Norwegian Agency for Development Cooperation (NORAD), the Swedish International Develop- ment Cooperation Agency (Sida), the Swedish Ministry for Foreign Af- fairs and the David and Lucile Packard Foundation. For more information, contact: Merrill Wolf Deputy Director, Public Affairs and Media Ipas Tel: +1-919-960-5612 mailto:wolfm@ipas.org -- A conference statement from Expanding Access: Advancing the Role of Midlevel Providers in Menstrual Regulation and Elective Abortion Care 2-6 December 2001 Pilanesberg National Park, South Africa Worldwide, nearly 80,000 women die every year and millions more suf- fer serious complications and disabilities from unsafe abortion, which is wholly preventable. Even in countries where abortion-related maternal mortality is low, women still often lack access to abortion care and other reproductive health services that they want and need. Increasing the accessibility of menstrual regulation (MR) and/or safe abortion care is a key strategy in reducing unacceptably high rates of maternal mortality and morbidity, and in ensuring women’s ability to exercise their sexual and reproductive rights. Since midlevel health care providers are more numerous and tend to be closer to women than physicians, they have a critical role to play in meeting women’s needs for postabortion care, MR and in circumstances where it is legal termination of pregnancy. Experience in Bangladesh, South Africa and several other countries demonstrates that authorizing, training and equipping midlevel pro- viders to deliver MR and/or abortion care can make an important dif- ference in improving women’s access to needed services. Creating an enabling environment to expand and strengthen midlevel providers’ scope of practice is especially important in situations where they are the principal or only health care providers in the communities where women live. As health care providers, researchers, policymakers and representa- tives of technical agencies, we, the participants in the first-ever international meeting exploring midlevel providers’ role in MR and abortion care, strongly believe: • that women deserve prompt access to high-quality MR and/or abortion care, • that it is essential for health systems to create policy and ser- vice-delivery environments that enable MR and/or abortion care to be as accessible as possible to women, and • that women’s access to such care can be greatly enhanced by better integrating these services into midlevel providers’ scope of prac- tice. All of us who are committed to enhancing women’s health and lives have a responsibility to facilitate women’s access to the reproduc- tive health care they want and need, including menstrual regulation and abortion care. This conference has strengthened our commitment to fulfill this critical mandate an effort in which midlevel providers clearly play a key role. As a network of concerned professionals, we call on gov- ernments, health policymakers, nongovernmental organizations, inter- national organizations, donors and others to take action in support of advancing the role of midlevel providers in menstrual regulation and safe abortion care. The 50 conference delegates included teams from 10 countries as well as representatives from the African Midwives Research Network, the International Confederation of Midwives, Partners in Population and Development, the Reproductive Health Alliance and the World Health Organization. Ipas and IHCAR, the coordinating agencies, would like to express appreciation for financial support from the Danish Inter- national Development Assistance (Danida), the Norwegian Agency for Development Cooperation (NORAD), the Swedish International Develop- ment Cooperation Agency (Sida), the Swedish Ministry for Foreign Af- fairs and the David and Lucile Packard Foundation. For additional information mailto:johnstonh@ipas.org -- To send a message to AFRO-NETS, write to: afro-nets@usa.healthnet.org To subscribe or unsubscribe, write to: majordomo@usa.healthnet.org in the body of the message type: subscribe afro-nets OR unsubscribe afro-nets To contact a person, send a message to: owner-afro-nets@usa.healthnet.org Information and archives: http://www.afronets.org