Successful provision of medical abortion by rural health extension workers, Ethiopia.
Article Type: Brief article
Subject: Abortion services (Laws, regulations and rules)
Rural health services (Laws, regulations and rules)
Pub Date: 05/01/2012
Publication: Name: Reproductive Health Matters Publisher: Elsevier Science Publishers Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2012 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2012 Source Volume: 20 Source Issue: 39
Topic: Event Code: 930 Government regulation; 940 Government regulation (cont); 980 Legal issues & crime; 970 Government domestic functions Advertising Code: 94 Legal/Government Regulation Computer Subject: Government regulation
Product: Product Code: 8082000 Abortion Clinics NAICS Code: 621498 All Other Outpatient Care Centers SIC Code: 8093 Specialty outpatient clinics, not elsewhere classified
Geographic: Geographic Scope: Ethiopia Geographic Name: Ethiopia; Ethiopia Geographic Code: 6ETHI Ethiopia
Accession Number: 296571590
Full Text: In Ethiopia abortion has been permitted in cases of risk to the woman's health, fetal abnormality after rape and for all girls under 18 years since 2005. The Comprehensive Abortion Care project has reduced unsafe abortion levels in the Tigray region through a rural health extension worker-led programme. A five-year programme evaluation found that unsafe abortion had stopped being the leading cause of admission to the regional hospital, falling to 10th cause and with no deaths or severe complications. 1,700 health extension workers working in 20 health centres, who received 18 months' training, provide medical abortion up to nine weeks and treat incomplete abortion with misoprostol. Nurses and health officers in nine health centres provide manual vacuum aspiration and medical abortion up to 12 weeks. Four hospitals provide full abortion care up to 28 weeks. The failure rate from oral use of misoprostol was 18%, which fell to 7% when treatment of incomplete abortion was included. Women reported preferring medical to surgical abortion. They sought help at a mean of nine weeks of pregnancy. Of the women followed up during the programme, 90% received contraceptive advice and almost half opted for injectables. Other regions are now planning to replicate. (1) However, access to safe abortion remains limited outside the capital; 30% of maternal deaths are still a result of unsafe abortion.

(1.) Prata N, Gessessew A, Campbell M, et al. "A new hope for women": medical abortion in a low-resource setting in Ethiopia. Journal of Family Planning and Reproductive Health Care 2011;37:196-97.

Doi: 10.1016/S0968-8080(12)39628-6
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