The PAC Connection e-Newsletter

MEETINGS AND CONFERENCES

Special Session on Postabortion Family Planning at International Family Planning Conference: "Postabortion Family Planning: What's Working in Africa"

"If the woman we treat for postabortion complications is there because she could not get contraception, we have failed her. If she leaves without family planning, we have failed her twice."
—PAC Consortium, International Conference on Population and Development (ICPD), Cairo, 1994

Approximately 100 people attended the Special Session on Postabortion Family Planning on November 29, 2011. The Special Session was co-sponsored by the USAID PAC Working Group and the PAC Connection and was held just prior to the 2011 International Conference on Family Planning in Dakar, Senegal. The topic of the meeting was "Postabortion Family Planning: What's Working in Africa," and participants hailed from a wide variety of nongovernmental organizations, academic institutions, hospitals, and USAID Missions from around the world. Presentations addressed three main themes:

(1) Strengthening postabortion FP service delivery
(2) Creating demand for postabortion FP from within the community
(3) Fostering an enabling environment where supportive policies permit and encourage the scale-up of interventions

FIGO, ICM, and ICN play a unique global advocacy role in terms of policy formation, ensuring access, sharing responsibility across professions, and strengthening professional education and curricula. This last theme emphasized how international professional associations (such as the FIGO, the ICM, and the ICN) would use the FP-PAC Joint Consensus Statement within their organizations and through interorganizational collaboration.

The dynamic session, opened by Mrs. Ramatoulaye Dioume from USAID/Senegal and chaired by Ms. Carolyn Curtis, PAC Champion USAID/Washington, included a moderated "talk show"-style panel with representatives from Guinea, Kenya, Rwanda, and Tanzania discussing successes they have achieved in diverse aspects of postabortion FP programming. Other agenda items included  a performance led by youth from Ndianda (about 100 km south of Dakar) along with representatives of various community groups (Young Mother's Group, Grandmother's Group, Heads of Households), and a presentation by Dr. John Townsend from the Population Council on Scaling-Up PAC.   

Data presented at the conference highlighted the need for postabortion FP and the potential impact of these services in terms of reducing maternal morbidity and mortality. Each year, 40% of pregnancies are unplanned and 20% result in unsafe abortion, reflecting a significant unmet need for FP around the world (Ahman & Shah, 2004; Singh et al., 2009). 

FP also reduces health care costs, because FP services generally cost less than PAC services. A World Bank study found that annually, PAC services cost four times as much FP services. Finally, FP can also save lives. If contraceptive services were provided to the 137 million women around the world who lack access to them, maternal mortality would decrease by 25-35% (Lule, Singh, & Chowdhury, 2007).

The country presentations highlighted a number of strategies that are working to increase access to postabortion FP in the five African countries that presented their programs. These strategies include:

• Strengthening community demand for PAC services, including use of the community action cycle
• Increasing access to long-acting and permanent methods of contraception
• Revising policy and service delivery guidelines to allow for task-shifting (enabling nurses or midwives to offer services previously provided only by doctors)
• Decentralizing services, to bring them closer to communities

References
Ahman, E., and Shah, I. 2004. Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000. Geneva: World Health Organization.  

Kidder, E., Sonneveldt, E., and Hardee, K. 2004. Who receives PAC services? Evidence from 14 countries. Washington, DC: The Futures Group, POLICY Project.

Lule, E., Singh, S., and Chowdhury, S. A. 2007. Fertility regulation behaviors and their costs: contraception and unintended pregnancies in Africa and Eastern Europe and Central Asia. Washington, DC: World Bank.

Singh, S., et al. 2009. Abortion worldwide: A decade of uneven progress. New York: Guttmacher Institute.