Healthy future for Nigerian women
Reported, December 10, 2011
Almost one-third of Nigerian women of childbearing age say they have had an unwanted pregnancy; of those, half have attempted to obtain an abortion. Unsafe abortion is one of the most significant and preventable causes of maternal death and injury in Nigeria. Research suggests that approximately 760,000 abortions occur each year (Bankole 2006) and that approximately 142,000 women are treated each year for complications from unsafe abortion (Henshaw 2008). Abortion is legally permitted only to save a womans life in Nigeria, which means that many induced abortions are clandestine and unsafe. Since the late 1980s, Ipas has worked successfully with government authorities, leading health-care providers, womens health advocates and other nongovernmental organizations to increase Nigerian womens access to high-quality postabortion care, including treatment for abortion complications and family planning counseling and services to help women prevent future unintended pregnancies. Through training, distribution of appropriate technologies and support to health-care facilities, Ipas and its partners have helped ensure the sustainability of this essential element of reproductive health care. Along with advocacy on behalf of womens rights, these collective efforts
have also significantly raised the profile of unsafe abortion as a topic for national discussion and helped erode the harmful stigma surrounding abortion.
Postabortion care a public health intervention that works
The impact of Ipas and its partners work in Nigeria can be illustrated in Kano, a socially conservative northern state facing daunting maternal health and other challenges Before Ipas introduced woman-centered postabortion care, women seeking treatment for complications of unsafe abortion overwhelmed many hospitals in the region. Some had only
one doctor and many more women in need of care than that
doctor could help.
Every morning, said Dr. H.M. Sadauki, former director of Murtala Mohammed Specialist Hospital, theyd be lying on the floor from the ward to theater, lined up waiting, wrapped only in a sheet. After the procedure, theyd be wheeled back to a place on the floor. Health-care workers difficulty meeting womens treatment
needs was due not only to the magnitude of the problem of unsafe abortion but also to how they provided care. Reliance on dilatation and curettage (D&C), a clinical method for uterine evacuation that employs sharp metal curettes to scrape out the lining of the uterus, meant that all such procedures were performed in the operating theater by doctors. Women typically had to stay in the hospital overnight, contributing to crowded
conditions and increasing costs.
Now, Murtala Mohammed Specialist Hospital offers state-ofthe-art postabortion care, and women and health-care providers alike benefit. Trained nurses and midwives treat women suffering from incomplete abortion with manual vacuum aspiration (MVA) in a dedicated procedure room. Care is available 24 hours a day. Women normally wait only 30 minutes to be treated, and most go home within an hour after treatment, after receiving
counseling and choosing a contraceptive method. Medical professionals take pride in their ability to provide women the care they need in a timely manner. All the attendant risks for women have been eliminated,
said Dr. Oladapo Shittu, who has implemented Ipass model of postabortion care as head of Obstetrics and Gynaecology at Ahmadu Bello University Teaching Hospital in Zaria. The expenses, the difficulties imposed on the health system. Those of us who have experience with both sides of it can tell you that it has helped tremendously.
Murtala Mohammed Hospital offers but one example of how Ipas has helped improve the quality and accessibility of postabortion care available to Nigerian women. In Kano State, hundreds of health-care workers have been trained to provide MVA and postabortion family planning in more than 30
facilities, making services accessible for women, even in remote parts of the region. Ipas and its partners have also made high-quality postabortion care nationally available, through training, distribution of MVA instruments, facility upgrades and ongoing support. As of late 2009, nearly 600 health-care facilities across the country, ranging from community-based clinics to large referral hospitals, provide woman-centered postabortion care. From July 2008 to June 2009 alone, nearly 9,000 MVA instruments were distributed in Nigeria enabling more than 200,000 women to be treated with this safe and effective technology.
To further sustain high-quality reproductive health care, Ipas also supports providers and facility managers in the field. In partnership with the Ministry of Health and the Nursing and Midwifery Council of Nigeria, Ipas instituted a program of facilitative supervision to improve the quality of abortion care at training and clinical sites. Four times each year, representatives of Ipas and local health authorities visit sites to review the
organization of services, recordkeeping practices, contraceptive services and instrument supplies.
Credits & More information:
http://www.ipas.org/Publications/asset_upload_file723_4668.pdf