Each year, women undergo an estimated 20 million unsafe abortions that result in nearly 70,000 deaths from complications. In 1994, the International Conference on Population and Development identified postabortion care (PAC) as a priority intervention to reduce maternal mortality. After this pivotal conference, Jhpiego, together with other cooperating agencies, founded the Postabortion Care Consortium to raise awareness about the contribution of incomplete and septic abortions on maternal death and disability, as well as to recognize unsafe abortions as an indicator of a high level of unmet need for family planning. Also in 1994, the U.S. Agency for International Development (USAID) established the Postabortion Care Working Group to promote quality PAC to reduce maternal morbidity and mortality and unplanned pregnancies.
In collaboration with the consortium, Jhpiego developed a PAC advocacy package containing video resources and statistics that was sent to almost 100 countries. Jhpiego also contributed to the development of a service delivery model for PAC that integrated three key components: emergency treatment, counseling on family planning methods and linkages to other health services, such as management of sexually transmitted diseases. Using a “no missed opportunities” approach, Jhpiego rolled out PAC as an integral part of reproductive health programs. In doing so, Jhpiego became one of the first organizations to translate research into practice by implementing the new PAC service delivery model in many countries around the world. Of note, the model broke new ground by systematically incorporating manual vacuum aspiration (MVA) to treat incomplete abortions, a transformational approach within PAC.
Following the start-up of PAC, Jhpiego expanded its global contributions by providing guidance on establishing PAC services in low-resource settings and contributing to the globally disseminated USAID PAC resource package, now available in English, French and Russian.
Today, most countries that initiated PAC under Jhpiego’s Global Training in Reproductive Health project, which ended in 2004, continue to offer PAC services. Guinea and Burkina Faso, for example, have leveraged funds from multilateral organizations, such as UNFPA, to continue PAC programs at national scale. The Ministry of Health in Nepa lis using its own funds to scale up PAC throughout the country, as well as to procure MVA equipment. The majority of women who come to facilities in these countries, and other areas where Jhpiego has implemented PAC, are being treated and are leaving with lifesaving family planning methods.
To date, in many countries in the developing world, PAC programs originally supported by Jhpiego are continuing, and hundreds if not thousands of women’s lives are being saved.